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 3245), BMI was 23.8 (IQR 2226) 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 307615), 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 0.080.89), P=0.032) and total body fat (OR 0.93 (95% CI 0.880.98), 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.
27 Apr - 01 May 2013
European Society of Endocrinology