男性HIV相关脂肪营养不良综合征患者骨矿含量DXA测量结果浅析

The changes of bone mineral content by DXA assessment in patients with HIV-associated lipodystrophy syndrome

目的分析HIV相关脂肪营养不良综合征患者的骨矿量(BMC)及骨密度(BMD)变化特点。方法 2002年1月至2009年12月在北京协和医院接受抗逆转录病毒治疗(HAART)治疗并行双能X线骨密度测量(DXA)检查的成年男性HIV/AIDS患者41例,年龄20～71岁,平均年龄(43±11)岁。根据患者主诉和医师评估结果,将上述患者分为脂肪营养不良(LD)组与非LD组,分析2组患者骨矿量及骨密度的差异。结果 41例HIV/AIDS患者中,经调整年龄、身高、体重,BMC与脂肪量(FM)间呈正向线性回归关系;LD组患者全身和局部骨BMC均低于非LD组患者,2组患者腰椎BMC差异有统计学意义(P=0.038);LD组患者腰椎和右髋部BMD均低于非LD组患者,2组患者腰椎BMD差异有统计学意义(P=0.028)。结论 DXA对评估HIV-LD患者的骨矿量变化有重要意义,可为骨质疏松的综合预防提供客观依据。

Objective To analyze the changes of bone mineral content （BMC） and bone mineral density （BMD） of HIV-associated lipodystrophy （HIV-LD） patients. Methods BMC and BMD ts were performed with DXA in a cohort of 41 HIV ＋ adult males who were on HAART regimen, mean age was 43 ＋ llyears, aged 20 -71 years. These HIV-infected men were divided into LD patients and Non-LD patients according to whether they were complicated with lipodystrophy. Results Multiple linear regression results showed that BMC had positive correlation with fat mass （FM）. Total and regional BMC of LD patients were lower than that of Non-LD patients, and trunk BMC had statistically difference between the two groups, P = 0. 038 ; Lower BMD in lumbar and in right hip were found in LD patients than that in Non-LD patients, lumbar BMD had significantly difference between the two groups P = 0. 028. Conclusion DXA could play an important role in evaluating the changes of HIV-LD patients＇ BMC and BMD and could provide objec- tive information for physicians to prevent osteopenia or osteoporosis.