Bone mass, fracture risk, and associated factors in postmenopausal women living with HIV.

OBJECTIVE: The aim of this study was to assess the prevalence of low bone mass (osteopenia/osteoporosis), the factors associated with low bone mass, and the risk of fractures in Brazilian postmenopausal women living with HIV (WLH) in the Amazon region. METHODS: This is a cohort study with a cross-sectional assessment at baseline conducted between March 2021 to August 2022 with 100 postmenopausal WLH undergoing antiretroviral therapy (ART) between 45 and 60 years of age and 100 age-matched HIV-negative women. Data on bone mineral density in the lumbar spine (LS) and femoral neck (FN) were collected using dual x-ray absorptiometry and the 10-year risk of hip and major osteoporotic fractures was assessed using the Fracture Risk Assessment tool (FRAX). RESULTS: The age of menopause onset occurred earlier in WLH ( P < 0.001). No differences in prevalence of osteoporosis and osteopenia in LS and FN were observed except for a lower T score in FN in WLH ( P = 0.039). The FRAX for major osteoporotic fracture and hip fracture were low in both groups, despite the mean of both FRAX scores was higher in WLH ( P < 0.001). Multivariate analysis showed that years since menopause onset, higher body mass index and higher FRAX major osteoporotic fracture were associated with the WLH group, while a higher frequency of physical activity was registered in the HIV-negative group. Multivariate analysis also showed that in WLH, a lower T score in FN was associated with years since menopause onset and body mass index and that the number of years since menopause onset was associated with a lower T score in the LS and a higher score in the FRAX hip fracture. CONCLUSIONS: Our findings show a high prevalence of low bone mass (osteopenia/osteoporosis) in Brazilian postmenopausal women from the Amazon region. Women living with HIV have higher FRAX scores than HIV-negative women and a lower T score in the FN.

Factors associated with bone density in young women with karyotypically normal spontaneous premature ovarian failure.

OBJECTIVE: To evaluate bone density and associated factors in women with premature ovarian failure (POF) compared to age-matched women with normal ovarian function. METHODS: A cross-sectional study of 50 patients with POF undergoing bone mineral densitometry was conducted, compared to 50 women paired by age who menstruated regularly. RESULTS: In women with POF, the mean bone mineral density measured was 1.22 g/cm(2) at the spine and 0.92 g/cm(2) at the femur, values which were significantly lower than in the control group (P < 0.0001). Factors directly associated with bone density of the lumbar spine were age and with bone density of the femur were BMI and reproductive age. CONCLUSION: Young women with POF have a decrease in lumbar spine and femoral bone density. Age, reproductive age and BMI were the factors associated with BMD. These women need early investigation and treatment to prevent bone loss and minimize fracture risk in the future.