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de Castro JAC, de Lima TR, Silva DAS. Health-Related Physical Fitness Evaluation in HIV-Diagnosed Children and Adolescents: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:541. [PMID: 38791753 PMCID: PMC11121308 DOI: 10.3390/ijerph21050541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/14/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Health-related physical fitness has been widely used to investigate the adverse effects of HIV infection/ART in children and adolescents. However, methods/protocols and cut-points applied for investigating health-related physical fitness are not clear. The aim of this scoping review was to map the literature to identify gaps in knowledge regarding the methods/protocols and cut-points. METHODS A scoping review, following the Joana Briggs Institute (JBI) guidelines, was conducted through ten major databases. Search followed the PCC strategy to construct block of terms related to population (children and adolescents), concept (health-related physical fitness components) and context (HIV infection). RESULTS The search resulted in 7545 studies. After duplicate removal, titles and abstracts reading and full text assessment, 246 studies were included in the scoping review. Body composition was the most investigated component (n = 244), followed by muscular strength/endurance (n = 23), cardiorespiratory fitness (n = 15) and flexibility (n = 4). The World Health Organization growth curves, and nationals' surveys were the most reference values applied to classify body composition (n = 149), followed by internal cut-points (n = 30) and cut-points developed through small populations (n = 16). Cardiorespiratory fitness was classified through cut-points from three different assessment batteries, as well as cut-points developed through studies with small populations, muscular strength/endurance and flexibility were classified through the same cut-points from five different assessment batteries. CONCLUSIONS The research on muscular strength/endurance, cardiorespiratory fitness and flexibility has been scarcely explored. The lack of studies that investigated method usability as well as reference values was evidenced.
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Affiliation(s)
- João Antônio Chula de Castro
- Graduate Program of Physical Education, Sports Center, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil; (J.A.C.d.C.); (T.R.d.L.)
| | - Tiago Rodrigues de Lima
- Graduate Program of Physical Education, Sports Center, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil; (J.A.C.d.C.); (T.R.d.L.)
- Graduate Program in Human Movement Sciences, University of the State of Santa Catarina, Florianopolis 88080-350, SC, Brazil
| | - Diego Augusto Santos Silva
- Graduate Program of Physical Education, Sports Center, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil; (J.A.C.d.C.); (T.R.d.L.)
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Milic J, Renzetti S, Morini D, Motta F, Carli F, Menozzi M, Cuomo G, Mancini G, Simion M, Romani F, Spadoni A, Baldisserotto I, Barp N, Diazzi C, Mussi C, Mussini C, Rochira V, Calza S, Guaraldi G. Bone Mineral Density and Trabecular Bone Score Changes throughout Menopause in Women with HIV. Viruses 2023; 15:2375. [PMID: 38140615 PMCID: PMC10747369 DOI: 10.3390/v15122375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE The objectives of this study were to describe the trajectories of bone mineral density (BMD) and trabecular bone score (TBS) changes throughout pre-menopause (reproductive phase and menopausal transition) and post-menopause (early and late menopause) in women with HIV (WWH) undergoing different antiretroviral therapies (ARTs) and explore the risk factors associated with those changes. METHODS This was an observational longitudinal retrospective study in WWH with a minimum of two DEXA evaluations comprising BMD and TBS measurements, both in the pre-menopausal and post-menopausal periods. Menopause was determined according to the STRAW+10 criteria, comprising four periods: the reproductive period, menopausal transition, and early- and late-menopausal periods. Mixed-effects models were fitted to estimate the trajectories of the two outcomes (BMD and TBS) over time. Annualized lumbar BMD and TBS absolute and percentage changes were calculated in each STRAW+10 time window. A backward elimination procedure was applied to obtain the final model, including the predictors that affected the trajectories of BMD or TBS over time. RESULTS A total of 202 WWH, all Caucasian, were included. In detail, 1954 BMD and 195 TBS data were analyzed. The median number of DEXA evaluations per woman was 10 (IQR: 7, 12). The median observation periods per patient were 12.0 years (IQR = 8.9-14.4) for BMD and 6.0 years (IQR: 4.3, 7.9) for TBS. The prevalence of osteopenia (63% vs. 76%; p < 0.001) and osteoporosis (16% vs. 36%; p < 0.001) increased significantly between the pre-menopausal and post-menopausal periods. Both BMD (1.03 (±0.14) vs. 0.92 (±0.12) g/cm2; p < 0.001) and TBS (1.41 (IQR: 1.35, 1.45) vs. 1.32 (IQR: 1.28, 1.39); p < 0.001) decreased significantly between the two periods. The trend in BMD decreased across the four STRAW+10 periods, with a slight attenuation only in the late-menopausal period when compared with the other intervals. The TBS slope did not significantly change throughout menopause. The delta mean values of TBS in WWH were lower between the menopausal transition and reproductive period compared with the difference between menopause and menopausal transition. CONCLUSIONS Both BMD and TBS significantly decreased over time. The slope of the change in BMD and TBS significantly decreased in the menopausal transition, suggesting that this period should be considered by clinicians as a key time during which to assess bone health and modifiable risk factors in WWH.
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Affiliation(s)
- Jovana Milic
- Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, 41121 Modena, Italy;
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy; (F.M.); (C.M.)
| | - Stefano Renzetti
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy;
| | - Denise Morini
- Hematology and Transplant Center, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy;
| | - Federico Motta
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy; (F.M.); (C.M.)
| | - Federica Carli
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Marianna Menozzi
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Gianluca Cuomo
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Giuseppe Mancini
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Mattia Simion
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Federico Romani
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Anna Spadoni
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Irene Baldisserotto
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Nicole Barp
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Chiara Diazzi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (C.D.); (V.R.)
| | - Chiara Mussi
- Department of Biomedical and Metabolic Sciences and Neuroscience, University of Modena and Reggio Emilia, 41126 Modena, Italy;
| | - Cristina Mussini
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy; (F.M.); (C.M.)
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
| | - Vincenzo Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (C.D.); (V.R.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, 41126 Modena, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy;
| | - Giovanni Guaraldi
- Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, 41121 Modena, Italy;
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy; (F.M.); (C.M.)
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, 41121 Modena, Italy; (F.C.); (M.M.); (G.C.); (G.M.); (M.S.); (F.R.); (A.S.); (I.B.); (N.B.)
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Roberts JA, Shen Y, Strehlau R, Patel F, Kuhn L, Coovadia A, Kaufman JJ, Shiau S, Arpadi SM, Yin MT. Comparison of quantitative ultrasonography and dual X-ray absorptiometry for bone status assessment in South African children living with HIV. PLoS One 2022; 17:e0276290. [PMID: 36251674 PMCID: PMC9576091 DOI: 10.1371/journal.pone.0276290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
Children living with HIV (CLHIV) have decreased bone mineral content (BMC) and density (BMD), increasing risk for fracture and future osteoporosis. While DXA is the gold-standard for bone assessments, it lacks availability in resource-constrained settings (RCS). Quantitative ultrasound (QUS) offers an alternative owing to its portability, low cost, ease of handling, and lack of ionizing radiation. While QUS has detected reduced bone quality in CLHIV, the relationship between QUS and DXA in this population remains unexplored. At baseline and 12 months, BMC and BMD of the whole body, lumbar spine, and radius were measured by DXA in a longitudinal cohort of CLHIV in Johannesburg, South Africa. Calcaneal speed of sound (SOS) and broadband ultrasound attenuation (BUA) and radius SOS were obtained by QUS, and calcaneal stiffness index (SI) was calculated. Spearman correlations, with and without HIV stratification, were performed between QUS and DXA measurements at each visit and for absolute difference in measurements between visits. At baseline and 12-months, calcaneal BUA and SI displayed strong positive correlations with DXA, with only modest correlations between radial QUS and DXA at baseline. Longitudinal measures of QUS did not correlate with DXA. At both baseline and 12-months, individuals with DXA whole-body BMD z-score < -1 displayed significantly lower calcaneal BUA and SI. Cross-sectionally, calcaneal QUS correlates strongly with whole body DXA and may represent a viable diagnostic alternative in RCS. Longitudinally, the two methods do not correlate well, possibly reflecting that each method assesses distinct aspects of bone architecture.
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Affiliation(s)
- Jackson A. Roberts
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America
| | - Yanhan Shen
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Renate Strehlau
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Faeezah Patel
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Louise Kuhn
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Ashraf Coovadia
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jonathan J. Kaufman
- Cyberlogic, Inc., New York, New York, United States of America
- Department of Orthopedics, The Mount Sinai Medical Center, New York, New York, United States of America
| | - Stephanie Shiau
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America
| | - Stephen M. Arpadi
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Department of Pediatrics, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Michael T. Yin
- Division of Infectious Disease, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
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