Cargando…
MON-385 Insulin Resistance and Osteoporosis in People Living with HIV
The life expectancy of people living with HIV (PLHIV) increased considerably after the advent of antiretroviral therapy (ARV). Nowadays, it is almost the same as the general population. However, this increase in survival exposes PLVH to age-related morbidities, including chronic metabolic and bone d...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207420/ http://dx.doi.org/10.1210/jendso/bvaa046.1255 |
_version_ | 1783530601069936640 |
---|---|
author | Premaor, Melissa Orlandin Caeran, Gabriela Almeida, Luciana Carvalho, Jose Stein, Carolina Moresco, Rafael Haygert, Carlos Comim, Fabio Vasconcellos |
author_facet | Premaor, Melissa Orlandin Caeran, Gabriela Almeida, Luciana Carvalho, Jose Stein, Carolina Moresco, Rafael Haygert, Carlos Comim, Fabio Vasconcellos |
author_sort | Premaor, Melissa Orlandin |
collection | PubMed |
description | The life expectancy of people living with HIV (PLHIV) increased considerably after the advent of antiretroviral therapy (ARV). Nowadays, it is almost the same as the general population. However, this increase in survival exposes PLVH to age-related morbidities, including chronic metabolic and bone diseases. PLHIV has a low bone mineral density (BMD) and a high prevalence of osteoporosis. Moreover, the frequency of diabetes mellitus (DM) seems to be twice the frequency of the general population. Insulin resistance and DM might be associated with bone diseases in PLHIV. Our study aim was to evaluate the association between insulin resistance and osteoporosis in PLHIV. We carried out a cross-sectional study at the municipality of Santa Maria, South Brazil. PLHIV age 50 yrs or over on treatment with ARV were included. All subjects registered to receive ARV in the university hospital during the period 2016 to 2018 were invited to participate. Those who accepted responded to a standardized questionnaire, performed a bone density scan and a lateral spinal X-ray, underwent peripheral blood collection, and had their weight and height measured. Insulin resistance was considered present when HOMA-IR> 2.7 (Gelonese, 2009). The TyG index was also calculated (VASQUES, 2011). Of the 101 PLHIV who agreed to participate, 84 underwent both insulin and BMD measurements. The prevalence of osteoporosis was 19%. Vertebral fractures were twice as frequent in individuals with osteoporosis (73.3% vs. 36.5%, p = 0.018). Participants with osteoporosis had lower BMI and triglyceride values than those without it. The frequency of insulin resistance calculated by HOMA-IR was 68.2%, and it was associated with glucocorticoid use, smoking, and BMI. HOMA-IR [4.8(6.6) vs. 8.68(9.6), p =0.013], and TyG [5.0(0.3) vs. 5.2 (0.4), p=0.029] mean values were lower in the group with osteoporosis; however, this association disappeared after correction for BMI in the logistic regression model. In conclusion, in our study, PLHIV with osteoporosis have lower insulin resistance than PLHIV without it. Nevertheless, this finding appears to be relating to a lower BMI. Further studies are needed to assess the effect of insulin resistance on fracture risk in PLVH. GELONEZE, B. et al. HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome: Brazilian Metabolic Syndrome Study (BRAMS). Arq Bras Endocrinol Metabol. 2009 Mar;53(2):281-7 VASQUES, A. C. et al. Análise Crítica do Uso dos Índices do Homeostasis Model Assessment (HOMA) na Avaliação da Resistência à Insulina e Capacidade Funcional das Células-C Pancreáticas. Arq. Bras. Endocrinol. Metab., 2008;52/1:32-39. |
format | Online Article Text |
id | pubmed-7207420 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-72074202020-05-13 MON-385 Insulin Resistance and Osteoporosis in People Living with HIV Premaor, Melissa Orlandin Caeran, Gabriela Almeida, Luciana Carvalho, Jose Stein, Carolina Moresco, Rafael Haygert, Carlos Comim, Fabio Vasconcellos J Endocr Soc Bone and Mineral Metabolism The life expectancy of people living with HIV (PLHIV) increased considerably after the advent of antiretroviral therapy (ARV). Nowadays, it is almost the same as the general population. However, this increase in survival exposes PLVH to age-related morbidities, including chronic metabolic and bone diseases. PLHIV has a low bone mineral density (BMD) and a high prevalence of osteoporosis. Moreover, the frequency of diabetes mellitus (DM) seems to be twice the frequency of the general population. Insulin resistance and DM might be associated with bone diseases in PLHIV. Our study aim was to evaluate the association between insulin resistance and osteoporosis in PLHIV. We carried out a cross-sectional study at the municipality of Santa Maria, South Brazil. PLHIV age 50 yrs or over on treatment with ARV were included. All subjects registered to receive ARV in the university hospital during the period 2016 to 2018 were invited to participate. Those who accepted responded to a standardized questionnaire, performed a bone density scan and a lateral spinal X-ray, underwent peripheral blood collection, and had their weight and height measured. Insulin resistance was considered present when HOMA-IR> 2.7 (Gelonese, 2009). The TyG index was also calculated (VASQUES, 2011). Of the 101 PLHIV who agreed to participate, 84 underwent both insulin and BMD measurements. The prevalence of osteoporosis was 19%. Vertebral fractures were twice as frequent in individuals with osteoporosis (73.3% vs. 36.5%, p = 0.018). Participants with osteoporosis had lower BMI and triglyceride values than those without it. The frequency of insulin resistance calculated by HOMA-IR was 68.2%, and it was associated with glucocorticoid use, smoking, and BMI. HOMA-IR [4.8(6.6) vs. 8.68(9.6), p =0.013], and TyG [5.0(0.3) vs. 5.2 (0.4), p=0.029] mean values were lower in the group with osteoporosis; however, this association disappeared after correction for BMI in the logistic regression model. In conclusion, in our study, PLHIV with osteoporosis have lower insulin resistance than PLHIV without it. Nevertheless, this finding appears to be relating to a lower BMI. Further studies are needed to assess the effect of insulin resistance on fracture risk in PLVH. GELONEZE, B. et al. HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome: Brazilian Metabolic Syndrome Study (BRAMS). Arq Bras Endocrinol Metabol. 2009 Mar;53(2):281-7 VASQUES, A. C. et al. Análise Crítica do Uso dos Índices do Homeostasis Model Assessment (HOMA) na Avaliação da Resistência à Insulina e Capacidade Funcional das Células-C Pancreáticas. Arq. Bras. Endocrinol. Metab., 2008;52/1:32-39. Oxford University Press 2020-05-08 /pmc/articles/PMC7207420/ http://dx.doi.org/10.1210/jendso/bvaa046.1255 Text en © Endocrine Society 2020. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Bone and Mineral Metabolism Premaor, Melissa Orlandin Caeran, Gabriela Almeida, Luciana Carvalho, Jose Stein, Carolina Moresco, Rafael Haygert, Carlos Comim, Fabio Vasconcellos MON-385 Insulin Resistance and Osteoporosis in People Living with HIV |
title | MON-385 Insulin Resistance and Osteoporosis in People Living with HIV |
title_full | MON-385 Insulin Resistance and Osteoporosis in People Living with HIV |
title_fullStr | MON-385 Insulin Resistance and Osteoporosis in People Living with HIV |
title_full_unstemmed | MON-385 Insulin Resistance and Osteoporosis in People Living with HIV |
title_short | MON-385 Insulin Resistance and Osteoporosis in People Living with HIV |
title_sort | mon-385 insulin resistance and osteoporosis in people living with hiv |
topic | Bone and Mineral Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207420/ http://dx.doi.org/10.1210/jendso/bvaa046.1255 |
work_keys_str_mv | AT premaormelissaorlandin mon385insulinresistanceandosteoporosisinpeoplelivingwithhiv AT caerangabriela mon385insulinresistanceandosteoporosisinpeoplelivingwithhiv AT almeidaluciana mon385insulinresistanceandosteoporosisinpeoplelivingwithhiv AT carvalhojose mon385insulinresistanceandosteoporosisinpeoplelivingwithhiv AT steincarolina mon385insulinresistanceandosteoporosisinpeoplelivingwithhiv AT morescorafael mon385insulinresistanceandosteoporosisinpeoplelivingwithhiv AT haygertcarlos mon385insulinresistanceandosteoporosisinpeoplelivingwithhiv AT comimfabiovasconcellos mon385insulinresistanceandosteoporosisinpeoplelivingwithhiv |