FRI0502 CORRELATION OF THE DAILY DIETARY INTAKE OF CALCIUM WITH THE LEVEL OF BONE MINERAL DENSITY IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION

Abstract

Background There are few studies in which the relationship between daily calcium intake and bone mineral density (BMD) in patients with human immunodeficiency virus (HIV) infection has been evaluated, as well as its correlation with other factors of risk for the development of fragility fractures in this population. Objectives To determine the correlation of daily calcium intake with the most predictive risk factors for fragility fracture in patients with HIV infection, as well as BMD values in a cohort of patients followed in a Tertiary Madrid hospital. Methods Cross-sectional evaluation of a prospective study carried out in a specialized unit in HIV/AIDS of a tertiary Madrid hospital. We included asymptomatic consecutive patients with HIV infection, older than 50 years, followed regularly between January 2014 and December 2016. Results A total of 128 patients were included (35 women, 27%), with a mean age of 57 years (range: 50-83) and body mass index of 23.8 kg/m2 (range: 15.6-33.5). The mean time of HIV infection was 256 months (range: 202-306) and of antiretroviral therapy (ART) 219.7 months (range: 156-247). The average calcium intake obtained by dietary calculation (without supplementation) was 563.8 g/day (462-2772). Among the risk factors for fragility fracture (included in the FRAX): 44 (34%) reported smoking, 11 (9%) family history of fracture, 54 (42%) previous history of fracture, 8 (6%) significant alcohol consumption and 25 (21%) renal tubular dysfunction. According to the WHO classification based on BMD at the level of lumbar spine (LS) 50 (39%) were classified as osteopenia and 43 (34%) as osteoporosis, while at the femoral neck level said proportions were 83 (65%) and 9 (7%), respectively. A correlation was found between higher calcium intake with a longer time of ART (rho = 0.2, p = 0.02), but not with the age or time of HIV infection. The calcium intake showed no correlation with serum calcium levels (rho = 0.05, p = 0.72), serum phosphorus levels or bone biomarkers such as alkaline phosphatase, osteocalcin or P1NP, but an inverse relationship with the levels of βcrosslaps (rho = -0.21; p = 0.02). Calcium intake was associated with greater exercise, assessed by the International Physical Activity Questionnaire (IPAQ) (rho 0.23; 0 = 0.01). The calcium intake was lower in patients with osteoporosis with respect to osteopenia or normal (hip 500 vs 580 vs 573, LS 507 vs 635 vs 585, respectively, p = 0.04 between osteoporosis/osteopenia). Although a lower calcium intake was found in patients with vertebral fractures, this was not significant (486 (236) vs 583 (317), p = 0.09). Conclusion Although recent meta-analyzes show that calcium intake in non-HIV population is not related to the development of fragility fractures, in our cohort (with the limitations of a cross-sectional study) a probable association of daily calcium intake with a low BMD is evidenced. These findings should be confirmed in the longitudinal analysis of the data of the cohort.