Abstract
Low bone mineral content (BMC) and bone mineral density (BMD) have been identified in human immunodeficiency virus (HIV)-infected children and adolescents. The direct adverse effects of HIV infection and combined antiretroviral therapy (ART) negatively contribute to bone metabolism. A direct relationship between muscle strength levels and BMD in HIV-infected adults and older adults has been described. However, it is unknown whether handgrip strength (HGS) is associated with bone mass in pediatric populations diagnosed with HIV. To ascertain whether HGS levels are associated with BMC and BMD in HIV-infected children and adolescents. Cross-sectional study conducted in Florianãpolis, Brazil, in 2016. The subjects were 65 children and adolescents (8-15 years) diagnosed with vertically-transmitted HIV. Subtotal and lumbar-spine BMC and BMD were obtained via dual-emission X-ray absorptiometry (DXA). HGS was measured using manual dynamometers. The covariates of sex, ART, CD4+ T lymphocytes and viral load were obtained through questionnaires and medical records. Sexual maturation was self-reported and physical activity was measured using accelerometers. Simple and multiple linear regression were used, with P < 0.05. HGS was directly associated with subtotal BMD (β = 0.002; R² = 0.670; P < 0.001), subtotal BMC (β = 0.090; R² = 0.734; P = 0.005) and lumbar-spine BMC (β = 1.004; R² = 0.656; P = 0.010) in the adjusted analyses. However, no significant association was found between HGS and lumbar-spine BMD (β = 0.001; R² = 0.464; P = 0.299). HGS was directly associated with BMD and BMC in HIV-infected children and adolescents.
Highlights
Low bone mineral content (BMC) and bone mineral density (BMD) have been identified in human immunodeficiency virus (HIV)-infected children and adolescents.[1]
In these HIV-infected children and adolescents, handgrip strength (HGS) was directly associated with subtotal BMD (β = 0.002; P < 0.001), even after adjustment for sex, sexual maturation, skin color, viral load, type of medication used and level of habitual physical activity
The main findings from the present study were that HGS was directly associated with BMD and BMC in HIV-infected children and adolescents
Summary
Low bone mineral content (BMC) and bone mineral density (BMD) have been identified in human immunodeficiency virus (HIV)-infected children and adolescents.[1]. Major efforts to attenuate bone loss have been based on pharmacological interventions (bisphosphonates)[7] and vitamin D and calcium supplementation, non-pharmacological strategies based on physical activity that promote gravitational overload (running and jumping) or muscle tension (strength training) have the capacity to induce bone formation stimuli and inhibit bone resorption.[8,9] Handgrip strength (HGS) enhancement exercises have been suggested as a strategy in HIV treatment because they improve cardiorespiratory fitness, body composition and weight control.[10] In the literature, a direct relationship between HGS levels and BMD in HIV-infected adults[11,12] and older adults[12] has already been described It is unknown whether HGS is associated with bone mass in pediatric populations diagnosed with HIV. CONCLUSION: HGS was directly associated with BMD and BMC in HIV-infected children and adolescents
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Schedule a callMore From: Sao Paulo medical journal = Revista paulista de medicina
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