ECE2013 Poster Presentations Calcium and Vitamin D metabolism (62 abstracts)
Vitamin D and sarcopenia in HIV-infected patients
Noemi Gonzélez Pérez de Villar 1 , Vicente Estrada Pérez 2 , Jose M Peña Sánchez de Rivera 3 , Antonio Zapatero Gaviria 1 , Rosa Villar Vicente 1 , Gloria Cánovas Molina 1 , Emilia Cancer Minchot 1 , Azucena Rodriguez Robles 1 , M Teresa Martinez Larrad 2 & Manuel Serrano Ríos 2
1Hospital Universitario de Fuenlabrada, Madrid, Spain; 2Hospital Universitario Clinico San Carlos, Madrid, Spain; 3Hospital Universitario La Paz, Madrid, Spain.
Introduction: Sarcopenia, an age-associated loss of skeletal muscle mass and function, has been related to higher mortality in general population as well as in HIV-infected patients. In elderly, sarcopenia is a marker of frailty. The aim of our study was to describe the prevalence of sarcopenia and related factors in HIV-infected population.
Methods: Skeletal muscle mass (SMM), total fat mass and body fat distribution were measured by DXA scan. Muscle mass index (MMI) was calculated (lower limb SMM/height2). Sarcopenia was defined as an MMI <2 SD from observed in general population (7.26 kg/m2 males, 5.5 females). Body fat distribution was determined by body fat index (trunk fat mass/limb fat mass). Plasma levels of 25-OH-vitamin D (VD) were measured by immunoassay.
Results: 321 HIV-infected patients were studied. 85% were male, median age was 38 years (IQR 32–45), BMI was 23.8 (IQR 22–26) kg/m2; 45% naive and 54% on antiretroviral therapy (ART). Previous AIDS diagnosis was present in 20%; median CD4 lymphocyte count was 454/μl (RIQ 307–615), HIV-1 viral load was undetectable (<50 cop/ml) in 84.3% of those on treatment. Hypovitaminosis D (<30 ng/ml) was present in 77%, being severe (<10 ng/ml) in 17%. The prevalence of sarcopenia was 23.5%. A low BMI, low waist circumference and less central body fat distribution were significantly associated to sarcopenia. In multivariate analysis, VD levels (OR 0.27 (95% CI 0.08–0.89), P=0.032) and total body fat (OR 0.93 (95% CI 0.88–0.98), P=0.008) were found to be associated to sarcopenia, after adjusting for age, sex, CD4 lymphocyte count and ART.
Conclusion: Sarcopenia is a frequent condition in HIV-infected patients despite the young age, affecting to 23.5% of our population. Increased VD levels and body fat mass may protect from it. Clinical studies on VD supplementation for sarcopenia prevention in HIV-infected patients are warranted.
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