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Background: Despite the gain in life expectancy that people living with HIV (PLHIV) have had in the past few years, the disease is accompanied by an increase in the prevalence of noninfectious chronic diseases. PLHIV have a higher prevalence of osteoporosis, fracture, diabetes mellitus, and insulin resistance than the general population. It is unknown if insulin resistance is associated with osteoporosis and fractures in PLHIV. Our study aimed to assess the association between insulin resistance and osteoporosis in PLHIV., Methods: A cross-sectional study was carried out in southern Brazil. PLHIV ages 50 years or older on antiretroviral treatment were included. Insulin resistance was considered present when the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was higher than expected for the Brazilian population (>2.7). The triglyceride-glucose (TyG) index was also calculated., Results: Of the 101 PLHIV who agreed to participate, 84 underwent insulin and bone mineral density measurements. The prevalence of osteoporosis was 19%. The frequency of insulin resistance calculated by HOMA-IR was 68.2%. Participants with osteoporosis had lower body mass index (BMI) and triglyceride values than those without it. HOMA-IR [4.8(6.6) vs 8.68(9.6), P = 0.013] and TyG [5.0(0.3) vs 5.2 (0.4), P = 0.029]. The association between the total femur t -score disappeared after correction for BMI in the linear regression model. There was no association between vertebral fractures and insulin resistance., Conclusion: In our study, PLHIV with osteoporosis have lower insulin resistance than PLHIV without it. However, this finding appears to be related to lower BMI. The association between insulin resistance and bone in PLHIV appears to be somewhat similar to that of the general population., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society.)

The prevalence of chronic diseases is increasing in people living with HIV (PLHIV) in the post ART era. Sarcopenia is prevalent in the elderly and is associated with many chronic diseases. Our study aimed to evaluate the frequency of sarcopenia in PLHIV and its association with bone mineral density and fracture. A cross-sectional study was carried out at Santa Maria, South Brazil. It included PLHV age ≥ 50 years and registered to receive antiretroviral therapy. A structured questionnaire was applied, blood samples collected, muscle strength evaluated, body composition measured, and vertebral morphometry performed. Sarcopenia and presarcopenia were defined according to the European Working Group on Sarcopenia in Older People. Of the 101 patients recruited, 83 underwent DXA and muscle strength measurements. The prevalence of sarcopenia and presarcopenia in the individuals studied was 12% and 16.9%, respectively. 66.7% of sarcopenic individuals had morphometric vertebral fractures and there was a tendency towards a higher frequency of multiple vertebral fractures when compared with non-sarcopenic subjects (44.4% vs. 16.2%, p = 0.066). BMI and total hip BMD were significantly lower in sarcopenic than non-sarcopenic individuals (p ≥ 0.035 and 0.032 respectively). In multiple regression analysis, sarcopenia was associated with age and multiple vertebral fractures. Sarcopenia was present in 12% of this population of PLHIV age ≥ 50 years and was associated with lower hip BMD and a high prevalence of vertebral fractures.