It is estimated that 400 million people in the world and 760,000 in Brazil are
carriers of the HIV. After the introduction of HAART in 1996, there were many changes
in the profile of HIV-associated diseases in which wasting syndrome and opportunistic
diseases gave rise to other conditions such as Lipodystrophy. The latter syndrome,
characterized by alterations in body fat distribution, has been associated with many
endocrine and metabolic disorders such as diabetes, dyslipidemia, hypogonadism,
hypovitaminosis D, osteopenia, osteoporosis. Several studies have been correlating
HIV with bone density loss, hypogonadism, and hypovitaminosis D. However, just a
few of them establish correlations between these factors and, furthermore, these
studies are still too controversial in order to make new screenings and therapies
protocols. Therefore, the main objective of this study was to correlate the levels of
sexual steroids, vitamin D and bone mineral density of men with HIV-associated
lipodystrophy. The current study brought together 36 HIV + men, users of ART, with a
diagnosis of lipodystrophy. The patients were subject to physical examination in order
to diagnose the form of lipodystrophy and complementary exams such as levels of
vitamin D, sex steroids, gonadotrophins, parathormone and prolactin. They were also
submitted to bone densitometry at two sites. The statistical analysis followed 95% as
the confidence level. The study found that HIV+ men with lipodystrophy had lower bone
mineral density and a higher prevalence of osteopenia and osteoporosis compared to
healthy men. Statistically significant association with T-score was obtained only for the
time since HIV diagnosis and for estradiol levels. When the variables were correlated
to the clinical form of bone densitometry alteration, only estradiol and ART time had a
statistically significant association, whereas FSH showed only tendency. Regarding
hypogonadism, the men in this study presented a higher prevalence in relation to
healthy men, predominating the hypogonadotropic form. In addition to not influencing
bone mineral density, vitamin D and free testosterone levels were not statistically
correlated with each other in this study. It was concluded that the main factors
associated with BMD loss were low estradiol levels, longer time since HIV diagnosis
and longer time of ART use.
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