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Sarcopenic obesity and reduced BMD in young men living with HIV: body composition and sex steroids interplay.

Authors :
De Vincentis S
Greco C
Fanelli F
Decaroli MC
Diazzi C
Mezzullo M
Milic J
De Santis MC
Roli L
Pagotto U
Guaraldi G
Rochira V
Source :
Journal of endocrinological investigation [J Endocrinol Invest] 2024 Nov; Vol. 47 (11), pp. 2715-2730. Date of Electronic Publication: 2024 Apr 20.
Publication Year :
2024

Abstract

Purpose: Sex steroids play a key role on male bone homeostasis and body composition (BC), their role in men living with HIV (MLWH) is less recognized. This study aimed at investigating the prevalence of low BMD, sarcopenia, and sarcopenic obesity (SO) and their relationship with sex steroids in MLWH aged < 50.<br />Methods: Prospective, cross-sectional, observational study on MLWH younger than 50 (median age 47.0 years). BC and BMD were evaluated with DXA. Two different definitions of sarcopenia were applied: appendicular lean mass/height <superscript>2</superscript> (ALMI) < 7.26 kg/m <superscript>2</superscript> or appendicular lean mass/body weight (ALM/W) < 28.27%. Low BMD was defined for Z-score < -2.0. Sarcopenia coupled with obesity identified SO. Serum total testosterone (T) and estradiol (E2) were measured by LC-MS/MS; free testosterone (cFT) was calculated by Vermeulen equation.<br />Results: Sarcopenia was detected in 107 (34.9%) and 44 (14.3%) out of 307 MLWH according to ALMI and ALM/W, respectively. The prevalence of SO was similar by using both ALMI (11.4%) and ALM/W (12.4%). Sarcopenic and SO MLWH had lower total T and cFT in both the definition for sarcopenia. BMD was reduced in 43/307 (14.0%). Serum E2 < 18 pg/mL was an independent contributing factor for sarcopenia, SO, and low BMD.<br />Conclusions: T and E2 are important determinants of BC even in MLWH. This is among the first studies investigating the distribution of obesity phenotypes and the prevalence of SO among MLWH showing that SO is present in 11-12% of enrolled MLWH regardless of the definition used. However, deep differences emerged using two different diagnostic definitions.<br /> (© 2024. The Author(s).)

Details

Language :
English
ISSN :
1720-8386
Volume :
47
Issue :
11
Database :
MEDLINE
Journal :
Journal of endocrinological investigation
Publication Type :
Academic Journal
Accession number :
38643322
Full Text :
https://doi.org/10.1007/s40618-024-02375-6