SEARCHCROSS-SECTIONALepidemiology, public health

cross-sectional·epidemiology, public health, endocrinology, internal medicine, geriatrics·PMC10071443

Osteoporosis, Rather Than Sarcopenia, Is the Predominant Musculoskeletal Disease in a Rural South African Community Where Human Immunodeficiency Virus Prevalence Is High: A Cross-Sectional Study

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 10 authors, 8 centres

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TL;DR

Sarcopenia was defined by EWGSOP2 guidelines, and osteoporosis by a femoral neck T-score ≤ −2.5 in those aged ≥50 years.

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Sarcopenia was defined by EWGSOP2 guidelines, and osteoporosis by a femoral neck T-score ≤ −2.5 in those aged ≥50 years. HIV infection was associated with a lower femoral neck BMD, with 37.1% of older women with HIV having femoral neck osteoporosis compared to 15.7% without HIV. Probable sarcopenia was low and more common in men than women, with no difference by HIV status.

STUDY TYPE

cross-sectional

SPECIALTY

epidemiology

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ORIGINAL PAPER

PMC10071443

Osteoporosis, Rather Than Sarcopenia, Is the Predominant Musculoskeletal Disease in a Rural South African Community Where Human Immunodeficiency Virus Prevalence Is High: A Cross-Sectional Study

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research

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ABSTRACT

The rollout of antiretroviral therapy globally has increased life expectancy across Southern Africa, where 20.6 million people now live with human immunodeficiency virus (HIV). We aimed to determine the prevalence of age-related osteoporosis and sarcopenia, and investigate the association between HIV, bone mineral density (BMD), muscle strength and lean mass, and gait speed. A cross-sectional community-based study of individuals aged 20–80 years in rural South Africa collected demographic and clinical data, including HIV status, grip strength, gait speed, body composition, and BMD. Sarcopenia was defined by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines, and osteoporosis as BMD T -score ≤ −2.5 (if age ≥50 years). The mean ± standard deviation (SD) age of 805 black South African participants was 44.6 ± 14.8 years, 547 (68.2%) were female; 34 (13.2%) were men, and 129 (23.6%) women had HIV, with 88% overall taking anti-retroviral therapy. A femoral neck T -score ≤ −2.5, seen in four of 95 (4.2%) men and 39 of 201 (19.4%) women age ≥50 years, was more common in women with than without HIV (13/35 [37.1%] versus 26/166 [15.7%]; p = 0.003). Although no participant had confirmed sarcopenia, probable sarcopenia affected more men than women (30/258 [11.6%] versus 24/547 [4.4%]; p = .001]. Although appendicular lean mass (ALM)/height 2 index was lower in both men and women with HIV, there were no differences in grip strength, gait speed, or probable sarcopenia by HIV status. Older age, female sex, lower ALM/height 2 index, slower gait speed, and HIV infection were all independently associated with lower femoral neck BMD. In conclusion, osteoporosis rather than sarcopenia is the common musculoskeletal disease of aging in rural South Africa; older women with HIV may experience greater bone losses than women without HIV. Findings raise concerns over future fracture risk in Southern Africa, where HIV clinics should consider routine bone health assessment, particularly in aging women.

CITATION EXPORT

Celia L. Gregson, Tafadzwa Madanhire, Andrea Rehman et al.. Osteoporosis, Rather Than Sarcopenia, Is the Predominant Musculoskeletal Disease in a Rural South African Community Where Human Immunodeficiency Virus Prevalence Is High: A Cross-Sectional Study. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. (2022). https://doi.org/10.1002/jbmr.4464

AUTHORS

10 · 8 CENTRES

Celia L. Gregson, Tafadzwa Madanhire, Andrea Rehman, Rashida A. Ferrand, Anne R. Cappola, Steven Tollman, Tshepiso Mokoena, Lisa K. Micklesfield, Alisha N. Wade, June Fabian

1Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
2SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
3Biomedical Research and Training Institute, Harare, Zimbabwe
4MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
5Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
6Division of Endocrinology, Diabetes, & Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
7MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
8Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa