Relationship between Presarcopenia and Trabecular Bone Score in HIV - Infected People

Objective: Antiretroviral therapy (ART) has transformed HIV-infection to a chronic disease. Nonetheless, since ART does not fully restore immune health, patients develop inflammation-associated complications considered the cornerstone in HIV-infection management. Osteoporosis is an important cause of morbidity in HIV-infected population and presarcopenia has emerged as important risk factor for osteoporosis. Trabecular bone score (TBS) is a novel method to evaluate bone microarchitecture. Our goal was to determine relationship between presarcopenia, osteoporosis and TBS in HIV- infected people. Methods: We designed a case-control study including 32 HIV-outpatients satisfying eligibility and exclusion criteria and 16 healthy-controls from local “TBS healthy-cohort”. Densitometry studies were using a dual-energy X-ray absorptiometry (DXA). TBS was evaluated at DXA lumbar spine image using TBSiNsight®v2.1. Skeletal muscle mass index (SMI) was defined as (appendicular skeletal muscle mass)/height2 (kg/m2 ). Presarcopenia was established as SMI <7.26 kg/m2 for men and SMI <5.55 kg/m2 for women. Results: Presarcopenia prevalence was 31% and osteoporosis 12.5% in cases. HIV-cases have more prevalence of low TBS (44% vs 12.5%, p=0.031). Regarding HIV-infected group, poor correlation was found between TBS and presarcopenia (r:-0.174, p=0.342). Nevertheless, strong correlation was observed between TBS and lumbar spine bone mineral density (BMD) (r:0.590, p=0.001), and good correlations between TBS and femoral neck BMD (r:0.395, p=0.025) and TBS and total hip (r:0.365, p=0.040). Conclusions: This is the first study that evaluates presarcopenia and TBS relationship in HIV-positive people and strong correlations between TBS and BMD were found in our population. Even so, further researches are needed to analyze this association.