Association between abdominal aortic calcifications, bone mineral density and vertebral fractures in a cohort of HIV‐positive patients
Introduction Evidence from HIV‐negative cohorts suggests a link between osteoporosis and cardiovascular disease. We evaluated the presence and distribution of abdominal aortic calcifications (AAC) and its correlation with bone mineral density (BMD) and vertebral fractures (VF) in a cohort of HIV‐pos...
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| Veröffentlicht in: | Journal of the International AIDS Society 2014-11, Vol.17 (4 Suppl 3), p.19715-n/a |
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| creator | Iannotti, Nathalie Gazzola, Lidia Savoldi, Alessia Suardi, Elisa Cogliandro, Viola Bai, Francesca Magenta, Alberto Peri, Mauro Bini, Teresa Marchetti, Giulia d'Arminio Monforte, Antonella |
| description | Introduction
Evidence from HIV‐negative cohorts suggests a link between osteoporosis and cardiovascular disease. We evaluated the presence and distribution of abdominal aortic calcifications (AAC) and its correlation with bone mineral density (BMD) and vertebral fractures (VF) in a cohort of HIV‐positive patients.
Materials and Methods
In this cross‐sectional study, 280 asymptomatic HIV‐positive patients from the SPID (“San Paolo” Infectious Diseases) cohort were submitted to lateral spine X‐ray and DXA. AAC was identified using the AAC‐8 score, which estimates the total length of calcification of the anterior and posterior aortic walls in front of vertebrae L1–L4. Low BMD was defined by T‐score or Z‐score |
| doi_str_mv | 10.7448/IAS.17.4.19715 |
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Evidence from HIV‐negative cohorts suggests a link between osteoporosis and cardiovascular disease. We evaluated the presence and distribution of abdominal aortic calcifications (AAC) and its correlation with bone mineral density (BMD) and vertebral fractures (VF) in a cohort of HIV‐positive patients.
Materials and Methods
In this cross‐sectional study, 280 asymptomatic HIV‐positive patients from the SPID (“San Paolo” Infectious Diseases) cohort were submitted to lateral spine X‐ray and DXA. AAC was identified using the AAC‐8 score, which estimates the total length of calcification of the anterior and posterior aortic walls in front of vertebrae L1–L4. Low BMD was defined by T‐score or Z‐score <−1 at lumbar spine or femoral neck. VF were identified by morph‐metric analysis of X‐ray and were defined by the “spine deformity index” (SDI) ≥1 according to semiquantitative method by Genant. Associations between AAC, BMD and SDI were evaluated by univariate and multivariate logistic regression models. The relationship between the grade of AAC and SDI was evaluated by Spearman's correlation.
Results
AAC≥1 was present in 65 patients (23.2%); of these 15 patients showed moderate/severe calcifications (AAC>2). Low BMD was found in 163 patients (58.2%) and VF (SDI≥1) in 47/274 patients (17.1%). By univariate analysis, factors associated with AAC>=1 were: age (for additional 10 years older HR 3.81 [IC95% 2.64–5.51], p<0.0001) lower CD4 nadir (for additional 50 CD4 HR 0.89 [IC95% 0.82–0.97], p=0.01) AIDS‐diagnosis (HR 2.13 [IC95 % 1.11–4.08], p=0.02) and being on HAART (HR 2.75 [IC95% 1.28–5.90], p=0.009). In multivariate analysis, only age (OR 2.62, IC95% 1.72–3.99, p<0.0001) resulted significantly associated with AAC≥1. Patients with AAC≥1 had twofold increase in the risk of low BMD (HR 2.45 [IC95% 1.32–4.45], p=0.004) and VF (SDI>=1: HR 2.17 [IC95% 1.1–4.2], p=0.02) compared to patients without AAC. The grade of AAC was directly correlated with the grade of SDI (rho=0.16; p=0.008): AAC>2 determines a sixfold increase in the risk of VF (HR 6.44 [IC95% 2.21–18.79], p=0.0006). AAC≥1 predict VF independently from BMD, vitamin D status and bone turnover marker (Table 1).
Conclusions
In our HIV population, AAC resulted a strong predictor of both low BMD and VF, irrespective of factors involved in bone formation. The grade of AAC was directly correlated with the grade of VF.</description><identifier>ISSN: 1758-2652</identifier><identifier>EISSN: 1758-2652</identifier><identifier>DOI: 10.7448/IAS.17.4.19715</identifier><identifier>PMID: 25397461</identifier><language>eng</language><publisher>Switzerland: International AIDS Society</publisher><subject>Acquired immune deficiency syndrome ; AIDS ; Bone density ; Bone mineral density ; Calcification ; Cardiovascular diseases ; Fractures ; Health aspects ; HIV ; HIV infection ; Human immunodeficiency virus ; Infectious diseases ; Multivariate analysis ; Osteoporosis ; Physiological aspects ; Risk factors ; Spine ; Vitamin D</subject><ispartof>Journal of the International AIDS Society, 2014-11, Vol.17 (4 Suppl 3), p.19715-n/a</ispartof><rights>2014 Iannotti N et al; licensee International AIDS Society</rights><rights>COPYRIGHT 2014 John Wiley & Sons, Inc.</rights><rights>2014. This work is published under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Iannotti N et al; licensee International AIDS Society 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4275-bc452385d7ab49a1dc58604a30652a56bc6b0de3d9b678e918f94eb28928efa23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225398/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225398/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1417,11561,27923,27924,45573,45574,46051,46475,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25397461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iannotti, Nathalie</creatorcontrib><creatorcontrib>Gazzola, Lidia</creatorcontrib><creatorcontrib>Savoldi, Alessia</creatorcontrib><creatorcontrib>Suardi, Elisa</creatorcontrib><creatorcontrib>Cogliandro, Viola</creatorcontrib><creatorcontrib>Bai, Francesca</creatorcontrib><creatorcontrib>Magenta, Alberto</creatorcontrib><creatorcontrib>Peri, Mauro</creatorcontrib><creatorcontrib>Bini, Teresa</creatorcontrib><creatorcontrib>Marchetti, Giulia</creatorcontrib><creatorcontrib>d'Arminio Monforte, Antonella</creatorcontrib><title>Association between abdominal aortic calcifications, bone mineral density and vertebral fractures in a cohort of HIV‐positive patients</title><title>Journal of the International AIDS Society</title><addtitle>J Int AIDS Soc</addtitle><description>Introduction
Evidence from HIV‐negative cohorts suggests a link between osteoporosis and cardiovascular disease. We evaluated the presence and distribution of abdominal aortic calcifications (AAC) and its correlation with bone mineral density (BMD) and vertebral fractures (VF) in a cohort of HIV‐positive patients.
Materials and Methods
In this cross‐sectional study, 280 asymptomatic HIV‐positive patients from the SPID (“San Paolo” Infectious Diseases) cohort were submitted to lateral spine X‐ray and DXA. AAC was identified using the AAC‐8 score, which estimates the total length of calcification of the anterior and posterior aortic walls in front of vertebrae L1–L4. Low BMD was defined by T‐score or Z‐score <−1 at lumbar spine or femoral neck. VF were identified by morph‐metric analysis of X‐ray and were defined by the “spine deformity index” (SDI) ≥1 according to semiquantitative method by Genant. Associations between AAC, BMD and SDI were evaluated by univariate and multivariate logistic regression models. The relationship between the grade of AAC and SDI was evaluated by Spearman's correlation.
Results
AAC≥1 was present in 65 patients (23.2%); of these 15 patients showed moderate/severe calcifications (AAC>2). Low BMD was found in 163 patients (58.2%) and VF (SDI≥1) in 47/274 patients (17.1%). By univariate analysis, factors associated with AAC>=1 were: age (for additional 10 years older HR 3.81 [IC95% 2.64–5.51], p<0.0001) lower CD4 nadir (for additional 50 CD4 HR 0.89 [IC95% 0.82–0.97], p=0.01) AIDS‐diagnosis (HR 2.13 [IC95 % 1.11–4.08], p=0.02) and being on HAART (HR 2.75 [IC95% 1.28–5.90], p=0.009). In multivariate analysis, only age (OR 2.62, IC95% 1.72–3.99, p<0.0001) resulted significantly associated with AAC≥1. Patients with AAC≥1 had twofold increase in the risk of low BMD (HR 2.45 [IC95% 1.32–4.45], p=0.004) and VF (SDI>=1: HR 2.17 [IC95% 1.1–4.2], p=0.02) compared to patients without AAC. The grade of AAC was directly correlated with the grade of SDI (rho=0.16; p=0.008): AAC>2 determines a sixfold increase in the risk of VF (HR 6.44 [IC95% 2.21–18.79], p=0.0006). AAC≥1 predict VF independently from BMD, vitamin D status and bone turnover marker (Table 1).
Conclusions
In our HIV population, AAC resulted a strong predictor of both low BMD and VF, irrespective of factors involved in bone formation. The grade of AAC was directly correlated with the grade of VF.</description><subject>Acquired immune deficiency syndrome</subject><subject>AIDS</subject><subject>Bone density</subject><subject>Bone mineral density</subject><subject>Calcification</subject><subject>Cardiovascular diseases</subject><subject>Fractures</subject><subject>Health aspects</subject><subject>HIV</subject><subject>HIV infection</subject><subject>Human immunodeficiency virus</subject><subject>Infectious diseases</subject><subject>Multivariate analysis</subject><subject>Osteoporosis</subject><subject>Physiological aspects</subject><subject>Risk factors</subject><subject>Spine</subject><subject>Vitamin D</subject><issn>1758-2652</issn><issn>1758-2652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqFks9v0zAUxyMEYmNw5YgsISEOtNiOYzuXSdUErGgSB35cLcd5aT2lcbGTTr1x5MjfyF_CSzdGhypQDo7sz_v66_e-WfaU0akSQr-ezz5OmZqKKSsVK-5lx0wVesJlwe_v_R9lj1K6pFRyLcqH2REv8lIJyY6z77OUgvO296EjFfRXAB2xVR1WvrMtsSH23hFnW-cb73ZYekWq0AFBAiIyNXTJ91tiu5psIPZQjbtNtK4fIiTiUZC4sEQpEhpyPv_y89uPdcAavwGyRk3o-vQ4e9DYNsGTm_Uk-_z2zaez88nFh3fzs9nFxAmuiknlRMFzXdTKVqK0rHaFllTYnOIzbSErJytaQ16XlVQaSqabUkDFdck1NJbnJ9npte56qFZQO7wb7Zp19CsbtyZYb-6edH5pFmFjBB-7plHg5Y1ADF8HSL1Z-eSgbW0HYUiGSS6ZzJmWiD7_C70MQ8S-JoN-lcypoOJfFEffKqdM0j_UwrZgfNcEdOfGq81M8VxSWeYjNTlALWA3KRxa43H7Dj89wONXw8q7gwUv9gqWYNt-mUI77IJxUNnFkFKE5rbFjJoxugaja5gywuyiiwXP9gdzi__OKgLiGrhCT9v_yJn38xnf6f4Cab75Xg</recordid><startdate>201411</startdate><enddate>201411</enddate><creator>Iannotti, Nathalie</creator><creator>Gazzola, Lidia</creator><creator>Savoldi, Alessia</creator><creator>Suardi, Elisa</creator><creator>Cogliandro, Viola</creator><creator>Bai, Francesca</creator><creator>Magenta, Alberto</creator><creator>Peri, Mauro</creator><creator>Bini, Teresa</creator><creator>Marchetti, Giulia</creator><creator>d'Arminio Monforte, Antonella</creator><general>International AIDS Society</general><general>John Wiley & Sons, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201411</creationdate><title>Association between abdominal aortic calcifications, bone mineral density and vertebral fractures in a cohort of HIV‐positive patients</title><author>Iannotti, Nathalie ; Gazzola, Lidia ; Savoldi, Alessia ; Suardi, Elisa ; Cogliandro, Viola ; Bai, Francesca ; Magenta, Alberto ; Peri, Mauro ; Bini, Teresa ; Marchetti, Giulia ; d'Arminio Monforte, Antonella</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4275-bc452385d7ab49a1dc58604a30652a56bc6b0de3d9b678e918f94eb28928efa23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>AIDS</topic><topic>Bone density</topic><topic>Bone mineral density</topic><topic>Calcification</topic><topic>Cardiovascular diseases</topic><topic>Fractures</topic><topic>Health aspects</topic><topic>HIV</topic><topic>HIV infection</topic><topic>Human immunodeficiency virus</topic><topic>Infectious diseases</topic><topic>Multivariate analysis</topic><topic>Osteoporosis</topic><topic>Physiological aspects</topic><topic>Risk factors</topic><topic>Spine</topic><topic>Vitamin D</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iannotti, Nathalie</creatorcontrib><creatorcontrib>Gazzola, Lidia</creatorcontrib><creatorcontrib>Savoldi, Alessia</creatorcontrib><creatorcontrib>Suardi, Elisa</creatorcontrib><creatorcontrib>Cogliandro, Viola</creatorcontrib><creatorcontrib>Bai, Francesca</creatorcontrib><creatorcontrib>Magenta, Alberto</creatorcontrib><creatorcontrib>Peri, Mauro</creatorcontrib><creatorcontrib>Bini, Teresa</creatorcontrib><creatorcontrib>Marchetti, Giulia</creatorcontrib><creatorcontrib>d'Arminio Monforte, Antonella</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the International AIDS Society</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iannotti, Nathalie</au><au>Gazzola, Lidia</au><au>Savoldi, Alessia</au><au>Suardi, Elisa</au><au>Cogliandro, Viola</au><au>Bai, Francesca</au><au>Magenta, Alberto</au><au>Peri, Mauro</au><au>Bini, Teresa</au><au>Marchetti, Giulia</au><au>d'Arminio Monforte, Antonella</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between abdominal aortic calcifications, bone mineral density and vertebral fractures in a cohort of HIV‐positive patients</atitle><jtitle>Journal of the International AIDS Society</jtitle><addtitle>J Int AIDS Soc</addtitle><date>2014-11</date><risdate>2014</risdate><volume>17</volume><issue>4 Suppl 3</issue><spage>19715</spage><epage>n/a</epage><pages>19715-n/a</pages><issn>1758-2652</issn><eissn>1758-2652</eissn><abstract>Introduction
Evidence from HIV‐negative cohorts suggests a link between osteoporosis and cardiovascular disease. We evaluated the presence and distribution of abdominal aortic calcifications (AAC) and its correlation with bone mineral density (BMD) and vertebral fractures (VF) in a cohort of HIV‐positive patients.
Materials and Methods
In this cross‐sectional study, 280 asymptomatic HIV‐positive patients from the SPID (“San Paolo” Infectious Diseases) cohort were submitted to lateral spine X‐ray and DXA. AAC was identified using the AAC‐8 score, which estimates the total length of calcification of the anterior and posterior aortic walls in front of vertebrae L1–L4. Low BMD was defined by T‐score or Z‐score <−1 at lumbar spine or femoral neck. VF were identified by morph‐metric analysis of X‐ray and were defined by the “spine deformity index” (SDI) ≥1 according to semiquantitative method by Genant. Associations between AAC, BMD and SDI were evaluated by univariate and multivariate logistic regression models. The relationship between the grade of AAC and SDI was evaluated by Spearman's correlation.
Results
AAC≥1 was present in 65 patients (23.2%); of these 15 patients showed moderate/severe calcifications (AAC>2). Low BMD was found in 163 patients (58.2%) and VF (SDI≥1) in 47/274 patients (17.1%). By univariate analysis, factors associated with AAC>=1 were: age (for additional 10 years older HR 3.81 [IC95% 2.64–5.51], p<0.0001) lower CD4 nadir (for additional 50 CD4 HR 0.89 [IC95% 0.82–0.97], p=0.01) AIDS‐diagnosis (HR 2.13 [IC95 % 1.11–4.08], p=0.02) and being on HAART (HR 2.75 [IC95% 1.28–5.90], p=0.009). In multivariate analysis, only age (OR 2.62, IC95% 1.72–3.99, p<0.0001) resulted significantly associated with AAC≥1. Patients with AAC≥1 had twofold increase in the risk of low BMD (HR 2.45 [IC95% 1.32–4.45], p=0.004) and VF (SDI>=1: HR 2.17 [IC95% 1.1–4.2], p=0.02) compared to patients without AAC. The grade of AAC was directly correlated with the grade of SDI (rho=0.16; p=0.008): AAC>2 determines a sixfold increase in the risk of VF (HR 6.44 [IC95% 2.21–18.79], p=0.0006). AAC≥1 predict VF independently from BMD, vitamin D status and bone turnover marker (Table 1).
Conclusions
In our HIV population, AAC resulted a strong predictor of both low BMD and VF, irrespective of factors involved in bone formation. The grade of AAC was directly correlated with the grade of VF.</abstract><cop>Switzerland</cop><pub>International AIDS Society</pub><pmid>25397461</pmid><doi>10.7448/IAS.17.4.19715</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Wiley Online Library Open Access; EZB-FREE-00999 freely available EZB journals; Wiley Online Library All Journals; PubMed Central |
| subjects | Acquired immune deficiency syndrome AIDS Bone density Bone mineral density Calcification Cardiovascular diseases Fractures Health aspects HIV HIV infection Human immunodeficiency virus Infectious diseases Multivariate analysis Osteoporosis Physiological aspects Risk factors Spine Vitamin D |
| title | Association between abdominal aortic calcifications, bone mineral density and vertebral fractures in a cohort of HIV‐positive patients |
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