Lean mass (LM) has a greater effect on bone mineral density (BMD) than fat mass (FM): data from a cohort of HIV-positive and HIV-negative subjects

The difference in BMD between HIV-positive and HIV-negative subjects may be explained by differences in weight. We aimed to determine the relative contributions of HIV infection, FM and LM on low BMD. HIV UPBEAT enrolled 210 HIV-positive and 264 HIV-negative subjects; demographic, clinical and laboratory data were collected. Body composition (LM, FM), femoral neck and lumbar spine densitometry were measured using dual-energy X-ray absorptiometry. Between-group differences were assessed using Wilcoxon tests; associations with FN and LS BMD were assessed using Spearman correlation and multivariable linear regression. Results are presented as median (interquartile range) unless specified. Lower LM and FM are independently associated with lower BMD; HIV-positive status remained independently associated with lower BMD after adjustment for LM and FM.