Dairy calcium intake and lifestyle risk factors for bone loss in hiv-infected and uninfected mediterranean subjects

• Main Authors: Vecchi Valentina, Soresi Maurizio, Giannitrapani Lydia, Mazzola Giovanni, La Sala Sara, Tramuto Fabio, Caruso Giuseppe, Colomba Claudia, Mansueto Pasquale, Madonia Simona, Montalto Giuseppe, Di Carlo Paola
• Format: Article
• Language: English
• Published: BMC 2012-08-01
• Series: BMC Infectious Diseases
• Subjects: HIV; Osteopenia; Osteoporosis; Dairy intake; Bone mineral density
• Online Access: http://www.biomedcentral.com/1471-2334/12/192

<p>Abstract</p> <p>Background</p> <p>Despite the reported high prevalence of osteoporosis in the human immunodeficiency virus (HIV)-population, there have been no previous studies examining dairy calcium intake and bone mineral density (BMD) in HIV-subjects.</p> <p>We assessed the prevalence of low BMD in HIV-infected and uninfected subjects and analyzed the effects of calcium intake, lifestyle and HIV-related risk factors on BMD.</p> <p>Methods</p> <p>One hundred and twelve HIV-infected subjects were consecutively enrolled. Seventy- six HIV-uninfected subjects matched for age and sex were enrolled as the control group. The HIV-subjects were interviewed about lifestyle habits and completed a weekly food-frequency questionnaire to estimate calcium intake. HIV-RNA, CD4+ T-cell count and data on antiretroviral therapy were also recorded. Both biochemical bone turnover markers and BMD, assessed by dual-energy radiographic absorptiometry (DXA) were recorded in the HIV-cases and controls. We also calculated the 10-year fracture risks using the WHO FRAX equation.</p> <p>Results</p> <p>Osteoporosis prevalence was significantly higher in the HIV-cases than controls (<it>p</it> < 0.05). BMI values were positively correlated with BMD (<it>p</it> < 0.05). Vitamin D levels were lower in the HIV-subjects (<it>p</it> < 0.02). No correlation was found with daily calcium intake.</p> <p>BMI values were significantly correlated with dairy intake quartiles (<it>p</it> < 0.003). In HIV-subjects, the mean of FRAX score was 1.2 % for hip and 4.7 % for major osteoporotic fractures. On multivariate analysis of the lumbar spine DXA T-score, age (<it>p</it> < 0.005) and HIV/hepatitis C virus co-infection (<it>p</it> < 0.0001) were negatively correlated with BMD, while yogurt intake was a protective predictor of BMD (<it>p</it> < 0.05). In the femur DXA T-score, age (<it>p</it> < 0.01), nadir CD4 + T-cell count < 200 cells/μL (<it>p</it> < 0.05) and drug addiction ( <it>p</it> < 0.0001) were negatively correlated with BMD.</p> <p>Conclusions</p> <p>Among the foods rich in calcium, yogurt was a protective predictor of BMD in HIV-subjects. HIV/HCV co-infection, nadir CD4 + T-cell count < 200 cells/μL and drug addiction were independent predictors of severe BMD. Promoting behavioral changes in food intake and lifestyle, aimed at the primary prevention of bone disease in the chronically-infected subjects seems to be essential for implementing medical intervention in these cases.</p>