Association between bone mineral density and content and physical growth parameters among children and adolescents diagnosed with HIV: a cross-sectional study

Abstract

BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/ height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

Health-Related Physical Fitness Evaluation in HIV-Diagnosed Children and Adolescents: A Scoping Review

“…In addition to that, studies that aimed to investigate the relationship between HIV infection/ART use and the health-related physical fitness components showed changes in the body fat distribution [91,104,194,264], reduction in the bone mass [15,84,108,124,209,262] and fat-free mass [8,102]. However, only 12.2% (n = 30) of the studies investigated more than one the health-related physical fitness component [21][22][23][24][25][26][27][28][29][30][31]33,34,41,47,50,52,106,110,112,116,192,196,[221][222][223]226,230,233,238] and no study that investigated the relationship between the health-related physical fitness components was found. Muscular strength/endurance is directly associated with the amount of muscle fibers-that is, related to the amount of fat-free mass, specifically muscle tissue, as well as cardiorespiratory fitness-is directly associated with the amount of type I (oxidative) muscle fibers …”

“…Physical activity was investigated through different aims such as to investigate differences between HIV-diagnosed group compared to non-diagnosed groups [19,21,25,29,31,40,51,87,88,95,[98][99][100]106,108,109,112,115,143,198,204,234], to investigate the association between health-related physical fitness and physical activity level [18,29,33,42,95,99,100,124,197,210,227,238] and to adjust models through physical activity [18,36,37,42,230,231,233,238]. In addition to the assumption that improvements in physical activity level can result in improvements in health-related physical fitness components [48,49,53], it follows that physical activity can moderate the relationship between HIV infection/ART use and the health-related physical...…”

“…In addition to the assumption that improvements in physical activity level can result in improvements in health-related physical fitness components [48,49,53], it follows that physical activity can moderate the relationship between HIV infection/ART use and the health-related physical fitness components, as well the differences between HIV-diagnosed children and adolescents and their peers without IV infection diagnosis [48,49,53]. The twelve studies that investigated the association between health-related physical fitness and physical activity presented divergent results, either indicating association [18,29,33,95,99,124,227,238], or showing the absence of association [42,99,100,197,210,227,239]. Moreover, studies that used the physical activity level to adjust models observe that if physical activity was moderating the investigated relationships, no difference was shown in the results after the adjustments through physical activity [18,36,37,42,230,231,233,238].…”

“…The twelve studies that investigated the association between health-related physical fitness and physical activity presented divergent results, either indicating association [18,29,33,95,99,124,227,238], or showing the absence of association [42,99,100,197,210,227,239]. Moreover, studies that used the physical activity level to adjust models observe that if physical activity was moderating the investigated relationships, no difference was shown in the results after the adjustments through physical activity [18,36,37,42,230,231,233,238]. Those inconclusive results regarding the relationship between health-related physical fitness components and physical activity can be related to the use of different methods to investigate physical activity.…”

“…Those inconclusive results regarding the relationship between health-related physical fitness components and physical activity can be related to the use of different methods to investigate physical activity. Where the use of direct methods [25,31,238], considered reference methods to investigate the physical activity level [53,62,63], as well as indirect methods [21,112,115], considered as alternatives methods that are more accessible for epidemiological studies [53,62,63], was observed. Moreover, physical activity was classified using different reference values and cut-points.…”