Proteinuria is associated with fragility fractures both in men living with HIV and HIV-uninfected men, but is more common among PLWH, a study published in the Journal of Acquired Immune Deficiency Syndromes found.
Researchers analyzed data on urine protein and bone fracture histories from 947 PLWH and 969 HIV-negative men, all MSM ≥ 40 years old enrolled in the Multicenter AIDS Cohort Study (MACS). The adjusted hazard ratio for fractures in those with proteinuria compared to no protein in urine was 2.29, independent of serostatus. Proteinuria prevalence was 29% among participants living with HIV, nearly five times the 5% prevalence found among HIV-negative participants.
A surprise finding was the association of moderate to high alcohol intake with lower fracture risk. After further investigation, study authors concluded that people with comorbidities were more likely to stop drinking, so this result may reflect the fact that only comparatively healthy participants continued to consume alcohol to excess.
No association was found between fractures and estimated globular filtration rate, a marker of kidney function . However, few men in this cohort had impaired kidney function, limiting the relevance of the findings.
"These data highlight the importance of osteoporosis screening and treatment in PLWH with proteinuria," study authors concluded. They called for additional research into the underlying mechanisms behind this finding.