Effect of Testosterone Use on Bone Mineral Density in HIV-Infected Men

Philip M. Grant, Xiuhong Li, Lisa Paula Jacobson, Frank J. Palella, Lawrence A. Kingsley, Joseph Bernard Margolick, Adrian S Dobs, Jordan E. Lake, Keri Althoff, Todd T Brown

Research output: Contribution to journalArticle

Abstract

HIV-infected men have increased rates of osteoporosis and fracture compared to HIV-uninfected men. Testosterone use among HIV-infected men is common. In HIV-uninfected men, testosterone increases bone mineral density (BMD), but its effects have not been evaluated in HIV-infected men. In a substudy of Multicenter AIDS Cohort Study (MACS), the Bone Strength Substudy (BOSS) enrolled 202 HIV-infected and 201 HIV-uninfected men aged between 50 and 69 years. Study participants underwent dual-energy X-ray absorptiometry (DXA) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) and detailed assessment of osteoporosis risk factors. We used multivariable linear regression to determine associations and 95% confidence intervals (CIs) between self-reported testosterone use and T-scores at the LS, TH, and FN after adjustment for demographics, behavioral covariates, comorbidities, and other traditional osteoporosis risk factors. HIV-infected men reported more frequent testosterone use (22% vs. 4%; p < .001) and had lower median BMD T-score at TH than HIV-uninfected men (0.0 vs. 0.3; p = .045) but similar T-scores at LS and FN. In the overall study population, testosterone use was associated with significantly greater BMD T-score at LS (0.68; 95% CI: 0.22-1.13). In HIV-infected men with virologic suppression, testosterone was significantly associated with higher BMD T-score at LS (0.95; 95% CI: 0.36-1.54) and TH (0.45; 95% CI: 0.04-0.86). Current testosterone use is common in HIV-infected men and was associated with higher BMD, compared to those not taking testosterone. Testosterone's role in reducing fracture risk in HIV-infected men should be investigated.

Original languageEnglish (US)
Pages (from-to)75-80
Number of pages6
JournalAIDS Research and Human Retroviruses
Volume35
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Bone Density
Testosterone
HIV
Spine
Hip
Femur Neck
Confidence Intervals
Osteoporosis
Photon Absorptiometry
Comorbidity
Linear Models
Acquired Immunodeficiency Syndrome
Cohort Studies
Demography
Bone and Bones

Keywords

  • anti-HIV agents
  • bone density
  • HIV infection
  • humans
  • testosterone

ASJC Scopus subject areas

  • Immunology
  • Virology
  • Infectious Diseases

Cite this

Effect of Testosterone Use on Bone Mineral Density in HIV-Infected Men. / Grant, Philip M.; Li, Xiuhong; Jacobson, Lisa Paula; Palella, Frank J.; Kingsley, Lawrence A.; Margolick, Joseph Bernard; Dobs, Adrian S; Lake, Jordan E.; Althoff, Keri; Brown, Todd T.

In: AIDS Research and Human Retroviruses, Vol. 35, No. 1, 01.01.2019, p. 75-80.

Research output: Contribution to journalArticle

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abstract = "HIV-infected men have increased rates of osteoporosis and fracture compared to HIV-uninfected men. Testosterone use among HIV-infected men is common. In HIV-uninfected men, testosterone increases bone mineral density (BMD), but its effects have not been evaluated in HIV-infected men. In a substudy of Multicenter AIDS Cohort Study (MACS), the Bone Strength Substudy (BOSS) enrolled 202 HIV-infected and 201 HIV-uninfected men aged between 50 and 69 years. Study participants underwent dual-energy X-ray absorptiometry (DXA) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) and detailed assessment of osteoporosis risk factors. We used multivariable linear regression to determine associations and 95{\%} confidence intervals (CIs) between self-reported testosterone use and T-scores at the LS, TH, and FN after adjustment for demographics, behavioral covariates, comorbidities, and other traditional osteoporosis risk factors. HIV-infected men reported more frequent testosterone use (22{\%} vs. 4{\%}; p < .001) and had lower median BMD T-score at TH than HIV-uninfected men (0.0 vs. 0.3; p = .045) but similar T-scores at LS and FN. In the overall study population, testosterone use was associated with significantly greater BMD T-score at LS (0.68; 95{\%} CI: 0.22-1.13). In HIV-infected men with virologic suppression, testosterone was significantly associated with higher BMD T-score at LS (0.95; 95{\%} CI: 0.36-1.54) and TH (0.45; 95{\%} CI: 0.04-0.86). Current testosterone use is common in HIV-infected men and was associated with higher BMD, compared to those not taking testosterone. Testosterone's role in reducing fracture risk in HIV-infected men should be investigated.",
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