Sharma, Anjali; Ma, Yifei; Tien, Phyllis C.; Scherzer, Rebecca; Anastos, Kathryn; Cohen, Mardge H.; Hans, Didier; Yin, Michael T.
Objectives: We compared skeletal microarchitecture using Trabecular Bone Score (TBS) and evaluated relationships between change in TBS and lumbar spine (LS) bone mineral density (BMD) in women with and without HIV. Methods: Dual energy X-ray absorptiometry (DXA) was performed on 319 women with and 118 without HIV in the Women's Interagency HIV Study (WIHS) at baseline and 2 and 5 years, to measure regional BMD and lean and fat mass. TBS was extracted from LS DXA images and examined continuously and categorically [normal (≥1.35), intermediate (1.20-1.35), or degraded (≤1.20) microarchitecture]. Pearson correlation and linear regression examined associations of TBS with regional BMD at baseline and over time. Results: Women with HIV were older (43 vs. 37 yrs), more likely to be post-menopausal (27% vs. 4%), have lower baseline total fat mass, trunk fat and leg fat than uninfected women, degraded microarchitecture (27% vs. 9%, p=0.001), and lower baseline mean TBS (1.3±0.1 vs. 1.4±0.1,p<0.001). After adjusting for age, race, menopause status, and BMI, TBS remained lower in women with HIV (p<0.0001). Annual change in TBS correlated with LS BMD change among women with HIV (r=0.36,p<0.0001) and without HIV (r=0.26,p=0.02), however mean % annual TBS change did not differ by HIV status (-1.0%/yr±2.9% for HIV+ vs. -0.8%/yr±1.7% for HIV-,p=0.42). Conclusions: Women with HIV have worse bone microarchitecture than uninfected women, but annual percent change in LS BMD or TBS was similar. Use of TBS as an adjunct to BMD to improve prediction of fragility fractures in women with HIV merits further study.