Document Detail


Functional impairment is associated with low bone and muscle mass among persons aging with HIV infection.
MedLine Citation:
PMID:  23392468     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Disability and frailty are associated with osteoporosis, obesity, and sarcopenia. HIV-infected persons have early functional impairment, but the association between body composition and functional impairment is unknown.
METHODS: HIV-1-infected participants on combination antiretroviral therapy with virologic suppression, aged 45-65 years, had standardized physical function measures. In a nested analysis, 30 low- and 48 high-functioning cases and controls were matched by age, gender, and time since HIV diagnosis. Bone mineral density, fat mass, and lean body mass were assessed by dual-energy x-ray absorptiometry. Odds ratios (ORs) with 95% confidence intervals were obtained from conditional logistic regression.
RESULTS: Mean age was 53 years, mean CD4(+) lymphocytes 598 cells per microliter, and 96% had plasma HIV-1 RNA <50 copies per milliliter. Low- and high-function subjects had similar CD4(+) lymphocyte count and duration and type of antiretroviral therapy. Lower T scores at the hip [OR: 3.8 (1.1 to 12.5)] and lumbar spine [OR: 2.3 (1.1 to 4.5)] and lower lean body mass [OR: 1.1 (1.0 to 1.2)] were associated with significantly greater odds of low function (P ≤ 0.03). Lower insulin-like growth hormone [IGF-1; OR: 5.0 (1.4 to 20.0)] and IGF-1 binding protein-3 [OR: 3.3 (1.7 to 9.9)] increased the odds of low functional status (P ≤ 0.02). Fat mass and lower 25-OH vitamin D did not increase the odds of low functional status (P > 0.05).
CONCLUSIONS: Functional impairment in HIV-1-infected persons on successful antiretroviral therapy is associated with low muscle mass, low bone mineral density, and low IGF-1 and IGF-1 binding protein-3. These characteristics may be a manifestation of early "somatopause" in middle-aged HIV-infected adults.
Authors:
Kristine M Erlandson; Amanda A Allshouse; Catherine M Jankowski; Samantha MaWhinney; Wendy M Kohrt; Thomas B Campbell
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  63     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-13     Completed Date:  2013-07-08     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-15     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aging*
Aging, Premature
Anti-HIV Agents / therapeutic use
Body Fat Distribution
Body Mass Index
Bone Density
Bone and Bones / physiology
CD4 Lymphocyte Count
Disabled Persons
Female
Frail Elderly
HIV Infections / drug therapy,  pathology*
Humans
Insulin-Like Growth Factor Binding Protein 3 / blood
Insulin-Like Growth Factor I / analysis
Male
Middle Aged
Muscles / physiology
Osteoporosis / complications*
Sarcopenia / complications*
Grant Support
ID/Acronym/Agency:
5UL1TR000154/TR/NCATS NIH HHS; P30 DK048520/DK/NIDDK NIH HHS; P30 DK048520/DK/NIDDK NIH HHS; R03 AG040594/AG/NIA NIH HHS; T32 AI007447/AI/NIAID NIH HHS; T32 AI007447-1/AI/NIAID NIH HHS; UL1 TR000154/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Insulin-Like Growth Factor Binding Protein 3; 67763-96-6/Insulin-Like Growth Factor I
Comments/Corrections

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