Prevalence of low bone mineral density among people living with HIV

Figures & data

Table 1. Characteristics of patients with/without low bone mineral density (BMD)

	Total	Normal BMD	Low BMD	p-value*
	(n = 226)	(n = 96)	(n = 130)
	n (%)	n (%)	n (%)
Male	141 (62)	51 (53)	90 (69)
Female	85 (38)	45 (47)	40 (31)
Missing	0
Male	141 (62)	51 (53)	90 (69)
Age, years				<0.001
<50	45 (20)	31 (32)	14 (11)
50–60	113 (50)	45 (47)	68 (52)
>60	68 (30)	20 (21)	48 (37)
Missing	0
BMI				<0.01
<24	105 (47)	39 (41)	66 (51)
24–30	93 (41)	38 (39)	55 (42)
>30	28 (12)	20 (20)	9 (7)
Missing	0
Smoking
Never	85 (38)	42 (44)	43 (33)	0.03
Current smoker	57 (25)	16 (17)	41 (32)
Former smoker	84 (37)	38 (39)	46 (35)
Missing	0
Physical activity pr week				0.10
0–120 minutes	74 (33)	24 (25)	50 (38)
2–4 hours	68 (30)	33 (34)	35 (27)
More than 4 hours	84 (37)	39 (40)	45 (35)
Missing	0
Nadir CD4 cell count				0.47
<200	108 (48)	44 (46)	64 (49)
>200	112 (50)	51 (53)	61 (47)
Missing	6 (2)	1 (1)	5 (4)
Treatment w/Tenofovir				0.14
No	50 (22)	26 (27)	24 (18)
Yes	171 (76)	69 (72)	102 (78)
Missing	5 (2)	1 (1)	4 (4)
Treatment w/Protease inhibitors				0.32
No	78 (35)	30 (31)	48 (37)
Yes	143 (63)	65 (68)	78 (60)
Missing	5 (2)	1 (1)	4 (3)

* P values are based on the χ2-test

Table 2. Logistic regression analysis of low BMD

	Logistic regression with lowest BMD value				Mixed model with all bone measurements
	OR (95% CI)		OR (95% CI)		OR (95% CI)		OR (95% CI)
	Unadjusted	p-value	Adjusted*	p-value	Unadjusted	p-value	Adjusted*	p-value
Sex
Male	ref		ref		ref		ref
Female	0.50 (0.29; 0.87)	0.01	1.01 (0.47; 2.19)	0.98	0.46 (0.26: 0.81)	<0.01	0.96 (0.43; 2.12)	0.91
Age, years
<50	ref		ref		ref		ref
50–60	3.35 (1.60; 6.97)	<0.01	3.20 (1.18; 8.70)	0.03	3.54 (1.66: 7.55)	<0.01	3.22 (1.16; 8.98)	0.03
>60	5.31 (2.34; 12.05)	<0.001	4.60 (1.54; 13.68)	<0.01	6.72 (2.84: 15.91)	<0.001	5.94 (1.90; 18.54)	<0.01
BMI
<24	ref		ref		ref		ref
24–30	0.86 (0.48; 1.51)	0.59	0.84 (0.44; 1.60)	0.59	0.88 (0.37: 2.10)	0.77	0.86 (0.44; 1.67)	0.65
>30	0.28 (0.11; 0.68)	<0.01	0.23 (0.11; 0.79)	0.02	0.17 (0.01: 216.5)	0.63	0.27 (0.10; 0.74)	0.01
Measure site
col					ref		ref
Femur sin					0.04 (0.01: 0.33)	<0.01	0.35 (0.16; 0.76)	<0.01
Femur dxt					0.17 (0.03: 1.10)	0.06	0.34 (0.16; 0.72)	<0.01
Smoking
Never	ref		ref		ref		ref
Current	2.50 (1.22; 5.12)	0.01	1.64 (0.74; 3.64)	0.22	3.94 (0.10: 149.1)	0.46	1.85 (0.81; 4.20)	0.14
Former	1.18 (0.65; 2.17)	0.59	1.13 (0.58; 2.23)	0.73	1.54 (0.38: 6.30)	0.54	1.35 (0.66; 2.76)	0.41
Physical activity
0–120 minutes	ref		ref		ref		ref
2–4 hours	0.51 (0.26; 1.01)	0.05	0.45 (0.21; 0.96)	0.04	0.49 (0.11: 2.13)	0.34	0.44 (0.20; 0.97)	0.04
More than 4 hours	0.55 (0.29; 1.06)	0.09	0.57 (0.27; 1.19)	0.14	1.04 (0.23: 4.71)	0.96	0.52 (0.24; 1.11)	0.09
Nadir CD4 cell count
<200	ref		ref		ref		ref
≥200	0.82 (0.48; 1.40)	0.47	0.76 (0.41; 1.40)	0.37	0.83 (0.31: 2.23)	0.71	0.84 (0.45; 1.59)	0.60
Tx w/Tenofovir
No	ref		ref		ref		ref
Yes	1.60 (0.85; 3.02)	0.15	1.26 (0.62; 2.55)	0.53	1.51 (0.79: 2.87)	0.21	1.10 (0.53; 2.28)	0.80
Tx w/Protease Inhibitors
No	ref		ref		ref		ref
Yes	0.75 (0.43; 1.32)	0.32	0.82 (0.43; 1.55)	0.54	0.75 (0.42: 1.32)	0.32	0.83 (0.43; 1.59)	0.57

*Adjusted for all variables in table. Significant results are in bold.

Table 3. Logistic regression analysis of low BMD (lowest value of columna and fem.sin OR columna fem.dxt)

	Model w/col & left fem				Model w/col & right fem
	OR (95% CI)		OR (95% CI)		OR (95% CI)		OR (95% CI)
	Unadjusted	p-value	Adjusted*	p-value	Unadjusted	p-value	Adjusted*	p-value
Sex
Male	ref		ref		ref		ref
Female	0.63 (0.37: 1.08)	0.09	1.33 (0.62; 2.85)	0.47	0.48 (0.27: 0.82)	<0.01	1.05 (0.48; 2.29)	0.89
Age, years
<50	ref		ref		ref		ref
50–60	3.58 (1.70: 7.56)	0.001	3.77 (1.39; 10.22)	<0.01	4.00 (1.87: 8.52)	<0.001	4.04 (1.44; 11.33)	<0.01
>60	3.52 (1.57: 7.87)	<0.01	3.16 (1.08; 9.22)	0.04	6.60 (2.84: 15.31)	<0.001	6.08 (1.98; 18.62)	<0.01
BMI
<24	ref		ref		ref		ref
24–30	0.91 (0.52: 1.60)	0.74	0.92 (0.49; 1.72)	0.80	0.82 (0.46: 1.44)	0.48	0.77 (0.40; 1.48)	0.43
>30	0.36 (0.15: 0.86)	0.02	0.36 (0.49; 0.95)	0.04	0.29 (0.12: 0.71)	<0.01	0.31 (0.11; 0.82)	0.02
Smoking
Never	ref		ref		ref		ref
Current	2.15 (1.07: 4.30)	0.03	1.65 (0.76; 3.58)	0.21	2.62 (1.28: 5.38)	0.01	1.70 (0.76; 3.81)	0.20
Former	1.02 (0.56:1.87)	0.94	0.96 (0.49; 1.86)	0.90	1.13 (0.62: 2.06)	0.7	1.06 (0.53; 2.11)	0.87
Physical activity
0–120 minutes	ref		ref		ref		ref
2–4 hours	0.51 (0.26: 1.00)	0.05	0.48 (0.23; 0.99)	0.05	0.48 (0.24: 0.95)	0.03	0.43 (0.20; 0.93)	0.03
More than 4 hours	0.55 (0.28: 1.04)	0.06	0.59 (0.29; 1.21)	0.15	0.50 (0.26: 0.96)	0.04	0.52 (0.25; 1.09)	0.09
Nadir CD4 cell count
<200	ref		ref		ref		ref
≥200	0.76 (0.44: 1.26)	0.27	0.68 (0.37; 1.24)	0.20	0.80 (0.47: 1.35)	0.40	0.72 (0.38; 1.34)	0.30
Tx w/Tenofovir
No	ref		ref		ref		ref
Yes	1.59 (0.84: 3.00)	0.15	1.31 (0.65; 2.64)	0.45	1.80 (0.97: 3.50)	0.06	1.41 (0.69; 2.91)	0.35
Tx w/Protease Inhibitors
No	ref		ref		ref		ref
Yes	0.87 (0.50: 1.52)	0.63	0.95 (0.51; 1.77)	0.87	0.69 (0.39: 1.21)	0.19	0.75 (0.39; 1.43)	0.39

*Adjusted for all variables in table. Significant results are in bold