Racial differences in bone loss and relation to menopause among HIV-infected and uninfected women

Anjali Sharma, Peter L. Flom, Clifford J. Rosen, Ellie Schoenbaum

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To characterize changes in bone mineral density (BMD) according to race among HIV-infected and uninfected women, and to evaluate the relationship between race and menopause-related bone loss. Methods: Dual X-ray absorptiometry measured BMD on study entry and a minimum of 18. months later in 246 HIV-infected and 219 HIV-uninfected women in the Menopause Study. Linear regression analyses determined percent annual BMD change at the total hip (TH), femoral neck (FN), and lumbar spine (LS) after adjusting for potential confounders. Race-stratified and HIV-infected subgroup analyses were performed. Results: At baseline, mean age was 45. years, 19% of women were postmenopausal. HIV-infected women were more likely to be black (58% vs. 38%), and had lower BMI and less cigarette exposure when compared to HIV-uninfected women. Women who were perimenopausal at baseline and postmenopausal at follow-up had the greatest TH bone loss (-. 1.68%/yr, p. <. .0001) followed by those postmenopausal throughout (-. 1.02%/yr, p. =. .007). We found a significant interaction between HIV status and race in multivariate analyses of BMD change at the FN and TH. In race-stratified analyses, HIV infection was associated with TH BMD loss in non-black women. Black women experienced greater menopause-associated decline in TH BMD compared with non-black women. Conclusions: The association of HIV and BMD differs strikingly by race, as do the effects of the menopausal transition on bone. Determining the extent to which the effect of HIV on fracture risk varies by race will be crucial to identify HIV-infected women at greatest risk for osteoporotic fracture, particularly as they enter menopause.

Original languageEnglish (US)
Pages (from-to)24-30
Number of pages7
JournalBone
Volume77
DOIs
StatePublished - Aug 1 2015

Fingerprint

Menopause
HIV
Bone Density
Bone and Bones
Pelvic Bones
Femur Neck
Hip
Osteoporotic Fractures
Photon Absorptiometry
Tobacco Products
HIV Infections
Linear Models
Spine
Multivariate Analysis
Regression Analysis

Keywords

  • Bone mineral density
  • HIV
  • Menopause
  • Osteoporosis
  • Race
  • Women

ASJC Scopus subject areas

  • Physiology
  • Endocrinology, Diabetes and Metabolism
  • Histology

Cite this

Racial differences in bone loss and relation to menopause among HIV-infected and uninfected women. / Sharma, Anjali; Flom, Peter L.; Rosen, Clifford J.; Schoenbaum, Ellie.

In: Bone, Vol. 77, 01.08.2015, p. 24-30.

Research output: Contribution to journalArticle

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abstract = "Objective: To characterize changes in bone mineral density (BMD) according to race among HIV-infected and uninfected women, and to evaluate the relationship between race and menopause-related bone loss. Methods: Dual X-ray absorptiometry measured BMD on study entry and a minimum of 18. months later in 246 HIV-infected and 219 HIV-uninfected women in the Menopause Study. Linear regression analyses determined percent annual BMD change at the total hip (TH), femoral neck (FN), and lumbar spine (LS) after adjusting for potential confounders. Race-stratified and HIV-infected subgroup analyses were performed. Results: At baseline, mean age was 45. years, 19{\%} of women were postmenopausal. HIV-infected women were more likely to be black (58{\%} vs. 38{\%}), and had lower BMI and less cigarette exposure when compared to HIV-uninfected women. Women who were perimenopausal at baseline and postmenopausal at follow-up had the greatest TH bone loss (-. 1.68{\%}/yr, p. <. .0001) followed by those postmenopausal throughout (-. 1.02{\%}/yr, p. =. .007). We found a significant interaction between HIV status and race in multivariate analyses of BMD change at the FN and TH. In race-stratified analyses, HIV infection was associated with TH BMD loss in non-black women. Black women experienced greater menopause-associated decline in TH BMD compared with non-black women. Conclusions: The association of HIV and BMD differs strikingly by race, as do the effects of the menopausal transition on bone. Determining the extent to which the effect of HIV on fracture risk varies by race will be crucial to identify HIV-infected women at greatest risk for osteoporotic fracture, particularly as they enter menopause.",
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