Limb fat loss (lipoatrophy) may be associated with decreased bone density of the hips, according to a study presented at the 10th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV in London and reported by the National AIDS Treatment Advocacy Project.

Osteopenia—lower-than-average bone mineral density that can lead to the more serious osteoporosis and increase the risk of serious fractures—is a growing concern among people with HIV, particularly as they age. Researchers have noted that people with HIV may be at increased risk for osteopenia at a younger age than their HIV-negative counterparts, and have been trying to understand the risk factors that may be involved.

Julian Falutz, MD, of McGill University Health Center in Montreal and his colleagues studied the medical records of 129 HIV-positive men who had undergone dual-energy X-ray absorptiometry (DEXA) bone scans between 2000 and 2007. The average age of the participants at the time of the DEXA scan was 47. Most were on a protease inhibitor-based regimen.

After controlling for factors associated with bone mineral loss, such as smoking, age and total body mass, Falutz's team found that participants with lipoatrophy were far more likely to have osteopenia of the hip compared with participants who did not have lipoatrophy. The difference was statistically significant, meaning that it was too great to have occurred by chance. DEXA measurements of the spine, another common area of bone mineral loss, were not significantly different between the two groups.

The authors recommend preventing and treating lipoatrophy wherever possible and to conduct assessments of total body mass and bone mineral density in people with HIV at risk for lipoatrophy.