Impaired bone mineral accrual in prepubertal HIV-infected children: a cohort study

Brazilian Journal of Infectious Diseases

Oliveira, Fernanda Luisa Ceragioli¹  Succi, Regina Célia de Menezes¹  Teixeira, Patrícia Fonseca¹  Szejnfeld, Vera Lúcia¹  Palchetti, Cecília Zanin¹  Patin, Rose Vega¹  Machado, Daisy Maria¹ 

[1] Universidade Federal de São Paulo, São Paulo, Brazil

关键词:  HIV;    Child;    Body composition;    Bone mineral densityIntroductionRecent advances in antiretroviral therapy allowed more children and adolescents infected with HIV to enter adulthood;   

DOI  :  10.1016/j.bjid.2015.08.010

来源: Contexto

【 摘 要 】

OBJECTIVE: To evaluate bone mass accrual and determine the influence of clinical, anthropometric, dietary and biochemical parameters on bone mass.METHODS: A cohort study including 35 prepubertal HIV-infected children, between 7 and 12 years, attended at a referral center. At time 1 (T1) and time 2 (T2), patients were assessed according to clinical, anthropometric, dietary, biochemical parameters and bone mineral density (BMD). At T2, patients were divided into prepubertal and pubertal.RESULTS: Despite the increase in bone mass absolute values, there was no improvement in lumbar spine BMD (LSBMD) Z-score (p = 0.512) and worsening in total body BMD (TBMD) Z-score (p = 0.040). Pubertal patients (n = 19) showed higher bone mineral content (BMC) (p = 0.001), TBMD (p = 0.006) and LSBMD (p = 0.002) compared to prepubertal patients. After multivariate linear regression analysis, the predictors of bone mass in T1 were age, BMI and HAZ-scores for BMC; BMI Z-score, adequate serum magnesium concentration and dietary calcium intake for TBMD; adequate serum concentration of magnesium, BMI and HAZ-scores for LSBMD. In T2, age, total body fat and lean body mass (kg) for BMC; BMI Z-score and puberty for TBMD; dietary fat intake, BMI Z-score for BMD and puberty for LSBMD.CONCLUSION: HIV-infected children have compromised bone mass and the presence of puberty seems to provide suitability of these parameters. Adequate intake of calcium and fat appears to be protective for proper bone mass accumulation factor, as well as monitoring nutritional status and serum magnesium concentration.

【 授权许可】

Unknown