Table 2.
Alcohol use and change in bone mineral density in PLWH with substance dependence or ever injection drug use over each year of observation
| Characteristic | Year 1* (n=234) | Year 2** (n=127) | |
|---|---|---|---|
| Independent Variable: Alcohol Consumption | |||
| Grams of alcohol per day (g/d, mean ± SD) | 21.49 ± 38.27 | 16.24 ± 31.08 | |
| Number of heavy drinking daysa (mean ± SD) | 3.81 ± 6.39 | 3.07 ± 5.74 | |
| Number of days abstinent (mean ± SD) | 24.31 ± 7.39 | 25.25 ± 6.90 | |
| Mean alcohol exposure per day | |||
| 0 – <0.7 drinks/day | 61% (144) | 66% (84) | |
| 0.7 – 1.7 drinks/day | 13% (30) | 13% (16) | |
| >1.7 drinks/day | 26% (60) | 21% (27) | |
| Drinking | |||
| Abstinenceb | 21% (50) | 26% (33) | |
| Not-heavyc | 18% (43) | 24% (30) | |
| Heavyd | 27% (63) | 18% (23) | |
| Very heavye | 33% (78) | 32% (41) | |
| Dependent Variable | |||
| % change in femoral neck (mean ± SD) | −0.68 ± 5.29 | 0.51 ± 5.54 | |
| % change in total hip (mean ± SD) | 0.71 ± 3.51 | 0.71 ± 2.94 | |
| % change in total spine (mean ± SD) | 1.14 ± 4.06 | −0.15 ± 4.10 | |
| >6% decrease any site | 13% (30) | 13% (17) | |
| Any fracture | 7% (17) | 4% (5) | |
| Other Variables | |||
| No current ART | 11.1% (26) | 9.5% (12) | |
| Tenofovir and no protease inhibitors | 39.3% (92) | 33.9% (43) | |
| Tenofovir and protease inhibitors | 35.0% (82) | 33.9% (43) | |
| Protease inhibitors and no tenofovir | 8.6% (20) | 10.2% (13) | |
| All other | 6.0% (15) | 12.6% (16) | |
| Medications that increase BMDf | 17.1% (40) | 18.1% (23) | |
| Medications that decrease BMDg | 43.6% (102) | 43.3% (55) | |
| Secondary causes of low BMDh | 41.0% (96) | 39.4% (50) | |
Abbreviations: IQR, Interquartile range; BMI, body mass index; ART, antiretroviral therapy; BMD, bone mineral density; SD, standard deviation;
Year 1: n (%) Baseline to 12 month: 222 (95%), Baseline to 18 month: 8 (3%), Baseline to 24 month: 2 (1%), 6 to 12 month: 2 (1%)
Year 2: n (%) 12 month to 24 month: 124 (98%), 18 month to 24 month: 3 (2%)
Heavy drinking day: ≥5 drinks for males and ≥4 drinks for females
Abstinence: no drinking in past 30 days
Not heavy: drank, but did not exceed NIAAA daily (≥5 for males and ≥4 for females) or weekly ( >14 for males and >7 for females) limits in past 30 days
Heavy: exceeded NIAAA daily limits for ≤4 days/week in past 30 days
Very heavy: ≥5 days/week of heavy drinking (exceeding NIAAA daily limits) in past 30 days
Denosumab, progestin only, contraceptive (systemic, levonorgesterel), bisphosphonates, androgen/anabolics (testosterone, topical or transdermal), and estrogen (transdermal, oral).
Glucocorticoids (oral and inhaled), antiasthma (only budesonide/formoterol, fluticasone/salmeterol), anti-inflammatory (inhaled, including beclomethasone dipropionate, budesonide, ciclesonide, flunisolide, fluticasone, mometasone), anticonvulsants (only divalproex, phenytoin, carbamazepine), chemotherapeutic agents, anticoagulants, and depo-provera.
Primary hyperparathyroidism (252.01, 252.0), secondary, tertiary, unspecified, or ectopic hyperparathyroidism (252.00, 252.02, 252.08, 259.3, 252.0), Cushing’s syndrome (255), hyperthyroidism, Graves’ disease, toxic goiter (242.00, 242.0–242.4, 242.8, 242.90), male hypogonadism (257.1–257.2), premature menopause (256.2, 256.31, 256.39, 626.0, 627.4), hyperprolactinemia (253.1), acromegaly (253), panhypopituitarism (253.2), osteomalacia, hypovitaminosis D (268.0–268.9), celiac disease, sprue (579.0–579.1), malnutrition, malabsorption (263.0, 263.1, 263.9, 579.3, 579.8, 579.9), Crohn’s disease (555.0–555.9), ulcerative colitis (556.0–556.9), anorexia, bulimia nervosa (307.1, 307.51), primary biliary cirrhosis (571.6) chronic liver disease, cirrhosis (571.9), hemochromatosis (275), chronic kidney disease (585.0–585.6, 585.9), renal hyperparathyroidism (588.81, 588.8), renal osteodystrophy (588), hypercalciuria (275.4), renal tubular acidosis (588.88, 588.89), hypocalcemia (275.41), hypercalcemia (275.42), rheumatoid arthritis (714), systemic lupus erythematosus (273.1), monoclonal gammopathy of undetermined significance (273.1), multiple myeloma (203.00–203.01), mastocytosis (202.6, 757.33), leukemia (208.00–208.91), lymphoma (202.80–202.88), sickle cell anemia (282.60–282.69), thalassemia (282.4, 282.49), hemophilia (286), amyloidosis (277.3), hypophosphatasia (275.3), mastocytosis (757.33), gonadal dysgenesis, Turner’s, XO (758.6), Kleinfelter’s syndrome (758.7), pseudo/pseudohypoparathyroidism, nephrocalcinosis (275.49), cystic fibrosis (277.00–277.09), immobilization >3 months (780.72), previous organ transplant (V42.0–V42.9), hypervitaminosis A (278.2), aluminum toxicity (973.0 + E858.4), osteogenesis imperfect (756.51), Ehlers–Danlos syndrome (756.83), Marfan’s syndrome (759.82), Gaucher’s disease (272.7), homocystinuria (270.4), hypophosphatasia (275.3), gastrectomy (43620–43634, 43638, 43639), small bowel resection (44120–44128, 44202, 44203), bariatric surgery (43644, 43645, 43659, 43842–43848).