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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Interruption or deferral of antiretroviral therapy reduces markers of bone turnover compared with continuous therapy: the SMART Body Composition Substudy</title><author><name sortKey="Hoy, Jennifer" sort="Hoy, Jennifer" uniqKey="Hoy J" first="Jennifer" last="Hoy">Jennifer Hoy</name><affiliation><nlm:aff id="A1">The Alfred Hospital and Monash University, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Grund, Birgit" sort="Grund, Birgit" uniqKey="Grund B" first="Birgit" last="Grund">Birgit Grund</name><affiliation><nlm:aff id="A2">University of Minnesota, Minneapolis, USA</nlm:aff></affiliation></author><author><name sortKey="Roediger, Mollie" sort="Roediger, Mollie" uniqKey="Roediger M" first="Mollie" last="Roediger">Mollie Roediger</name><affiliation><nlm:aff id="A2">University of Minnesota, Minneapolis, USA</nlm:aff></affiliation></author><author><name sortKey="Ensrud, Kristine E" sort="Ensrud, Kristine E" uniqKey="Ensrud K" first="Kristine E." last="Ensrud">Kristine E. Ensrud</name><affiliation><nlm:aff id="A3">VA Medical Center and University of Minnesota, Minneapolis, USA</nlm:aff></affiliation></author><author><name sortKey="Brar, Indira" sort="Brar, Indira" uniqKey="Brar I" first="Indira" last="Brar">Indira Brar</name><affiliation><nlm:aff id="A4">Henry Ford Hospital, Detroit, USA</nlm:aff></affiliation></author><author><name sortKey="Colebunders, Robert" sort="Colebunders, Robert" uniqKey="Colebunders R" first="Robert" last="Colebunders">Robert Colebunders</name><affiliation><nlm:aff id="A5">Institute of Tropical Medicine, HIV AIDS Center, Antwerp, Belgium</nlm:aff></affiliation></author><author><name sortKey="De Castro, Nathalie" sort="De Castro, Nathalie" uniqKey="De Castro N" first="Nathalie" last="De Castro">Nathalie De Castro</name><affiliation><nlm:aff id="A6">AP-HP, Groupe Hospitalier Lariboisière Saint-Louis, F-75010, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Johnson, Margaret" sort="Johnson, Margaret" uniqKey="Johnson M" first="Margaret" last="Johnson">Margaret Johnson</name><affiliation><nlm:aff id="A7">Royal Free Hospital, London, UK</nlm:aff></affiliation></author><author><name sortKey="Sharma, Anjali" sort="Sharma, Anjali" uniqKey="Sharma A" first="Anjali" last="Sharma">Anjali Sharma</name><affiliation><nlm:aff id="A8">SUNY Downstate Medical Center, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Carr, Andrew" sort="Carr, Andrew" uniqKey="Carr A" first="Andrew" last="Carr">Andrew Carr</name><affiliation><nlm:aff id="A9">St. Vincent's Hospital and University of New South Wales, Sydney, Australia</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23299909</idno><idno type="pmc">3657331</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657331</idno><idno type="RBID">PMC:3657331</idno><idno type="doi">10.1002/jbmr.1861</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">002038</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002038</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Interruption or deferral of antiretroviral therapy reduces markers of bone turnover compared with continuous therapy: the SMART Body Composition Substudy</title><author><name sortKey="Hoy, Jennifer" sort="Hoy, Jennifer" uniqKey="Hoy J" first="Jennifer" last="Hoy">Jennifer Hoy</name><affiliation><nlm:aff id="A1">The Alfred Hospital and Monash University, Melbourne, Australia</nlm:aff></affiliation></author><author><name sortKey="Grund, Birgit" sort="Grund, Birgit" uniqKey="Grund B" first="Birgit" last="Grund">Birgit Grund</name><affiliation><nlm:aff id="A2">University of Minnesota, Minneapolis, USA</nlm:aff></affiliation></author><author><name sortKey="Roediger, Mollie" sort="Roediger, Mollie" uniqKey="Roediger M" first="Mollie" last="Roediger">Mollie Roediger</name><affiliation><nlm:aff id="A2">University of Minnesota, Minneapolis, USA</nlm:aff></affiliation></author><author><name sortKey="Ensrud, Kristine E" sort="Ensrud, Kristine E" uniqKey="Ensrud K" first="Kristine E." last="Ensrud">Kristine E. Ensrud</name><affiliation><nlm:aff id="A3">VA Medical Center and University of Minnesota, Minneapolis, USA</nlm:aff></affiliation></author><author><name sortKey="Brar, Indira" sort="Brar, Indira" uniqKey="Brar I" first="Indira" last="Brar">Indira Brar</name><affiliation><nlm:aff id="A4">Henry Ford Hospital, Detroit, USA</nlm:aff></affiliation></author><author><name sortKey="Colebunders, Robert" sort="Colebunders, Robert" uniqKey="Colebunders R" first="Robert" last="Colebunders">Robert Colebunders</name><affiliation><nlm:aff id="A5">Institute of Tropical Medicine, HIV AIDS Center, Antwerp, Belgium</nlm:aff></affiliation></author><author><name sortKey="De Castro, Nathalie" sort="De Castro, Nathalie" uniqKey="De Castro N" first="Nathalie" last="De Castro">Nathalie De Castro</name><affiliation><nlm:aff id="A6">AP-HP, Groupe Hospitalier Lariboisière Saint-Louis, F-75010, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Johnson, Margaret" sort="Johnson, Margaret" uniqKey="Johnson M" first="Margaret" last="Johnson">Margaret Johnson</name><affiliation><nlm:aff id="A7">Royal Free Hospital, London, UK</nlm:aff></affiliation></author><author><name sortKey="Sharma, Anjali" sort="Sharma, Anjali" uniqKey="Sharma A" first="Anjali" last="Sharma">Anjali Sharma</name><affiliation><nlm:aff id="A8">SUNY Downstate Medical Center, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Carr, Andrew" sort="Carr, Andrew" uniqKey="Carr A" first="Andrew" last="Carr">Andrew Carr</name><affiliation><nlm:aff id="A9">St. Vincent's Hospital and University of New South Wales, Sydney, Australia</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research</title><idno type="ISSN">0884-0431</idno><idno type="eISSN">1523-4681</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">Bone mineral density (BMD) declines significantly in HIV patients on antiretroviral therapy (ART). We compared the effects of intermittent versus continuous ART on markers of bone turnover in the Body Composition substudy of the Strategies for Management of AntiRetroviral Therapy (SMART) trial and determined whether early changes in markers predicted subsequent change in BMD. For 202 participants (median age 44 years, 17% female, 74% on ART) randomised to continuous or intermittent ART, plasma markers of inflammation and bone turnover were evaluated at baseline, months 4 and 12; BMD at the spine (dual X-ray absorptiometry [DXA] and computed tomography) and hip (DXA) was evaluated annually. Compared to the continuous ART group, mean bone-specific alkaline phosphatase (bALP), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), N-terminal cross-linking telopeptide of type 1 collagen (NTX), and C-terminal cross-linking telopeptide of type 1 collagen (βCTX) decreased significantly in the intermittent ART group, whereas RANKL and the RANKL:osteoprotegerin (OPG) ratio increased (all p≤0.002 at month 4 and month 12). Increases in bALP, osteocalcin, P1NP, NTX, and βCTX at month 4 predicted decrease in hip BMD at month 12, while increases in RANKL and the RANKL:OPG ratio at month 4 predicted increase in hip and spine BMD at month 12. This study has shown that compared with continuous ART, interruption of ART results in a reduction in markers of bone turnover and increase in BMD at hip and spine, and that early changes in markers of bone turnover predict BMD changes at 12 months.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8610640</journal-id><journal-id journal-id-type="pubmed-jr-id">104</journal-id><journal-id journal-id-type="nlm-ta">J Bone Miner Res</journal-id><journal-id journal-id-type="iso-abbrev">J. Bone Miner. Res.</journal-id><journal-title-group><journal-title>Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research</journal-title></journal-title-group><issn pub-type="ppub">0884-0431</issn><issn pub-type="epub">1523-4681</issn></journal-meta><article-meta><article-id pub-id-type="pmid">23299909</article-id><article-id pub-id-type="pmc">3657331</article-id><article-id pub-id-type="doi">10.1002/jbmr.1861</article-id><article-id pub-id-type="manuscript">NIHMS435343</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Interruption or deferral of antiretroviral therapy reduces markers of bone turnover compared with continuous therapy: the SMART Body Composition Substudy</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hoy</surname><given-names>Jennifer</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Grund</surname><given-names>Birgit</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Roediger</surname><given-names>Mollie</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Ensrud</surname><given-names>Kristine E.</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Brar</surname><given-names>Indira</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Colebunders</surname><given-names>Robert</given-names></name><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>De Castro</surname><given-names>Nathalie</given-names></name><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Johnson</surname><given-names>Margaret</given-names></name><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Sharma</surname><given-names>Anjali</given-names></name><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Carr</surname><given-names>Andrew</given-names></name><xref ref-type="aff" rid="A9">9</xref></contrib><contrib contrib-type="author"><collab>The INSIGHT SMART Body Composition Substudy Group</collab></contrib></contrib-group><aff id="A1"><label>1</label>The Alfred Hospital and Monash University, Melbourne, Australia</aff><aff id="A2"><label>2</label>University of Minnesota, Minneapolis, USA</aff><aff id="A3"><label>3</label>VA Medical Center and University of Minnesota, Minneapolis, USA</aff><aff id="A4"><label>4</label>Henry Ford Hospital, Detroit, USA</aff><aff id="A5"><label>5</label>Institute of Tropical Medicine, HIV AIDS Center, Antwerp, Belgium</aff><aff id="A6"><label>6</label>AP-HP, Groupe Hospitalier Lariboisière Saint-Louis, F-75010, Paris, France</aff><aff id="A7"><label>7</label>Royal Free Hospital, London, UK</aff><aff id="A8"><label>8</label>SUNY Downstate Medical Center, New York, USA</aff><aff id="A9"><label>9</label>St. Vincent's Hospital and University of New South Wales, Sydney, Australia</aff><author-notes><corresp id="CR1"><bold>Corresponding author:</bold> Jennifer Hoy MBBS, FRACP Infectious Diseases Unit The Alfred Hospital 81 Commercial Rd, Melbourne, Victoria, 3004, Australia Phone: +61 3 9076 6900 <email>jennifer.hoy@monash.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>5</day><month>2</month><year>2013</year></pub-date><pub-date pub-type="ppub"><month>6</month><year>2013</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>6</month><year>2014</year></pub-date><volume>28</volume><issue>6</issue><fpage>1264</fpage><lpage>1274</lpage><abstract><p id="P1">Bone mineral density (BMD) declines significantly in HIV patients on antiretroviral therapy (ART). We compared the effects of intermittent versus continuous ART on markers of bone turnover in the Body Composition substudy of the Strategies for Management of AntiRetroviral Therapy (SMART) trial and determined whether early changes in markers predicted subsequent change in BMD. For 202 participants (median age 44 years, 17% female, 74% on ART) randomised to continuous or intermittent ART, plasma markers of inflammation and bone turnover were evaluated at baseline, months 4 and 12; BMD at the spine (dual X-ray absorptiometry [DXA] and computed tomography) and hip (DXA) was evaluated annually. Compared to the continuous ART group, mean bone-specific alkaline phosphatase (bALP), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), N-terminal cross-linking telopeptide of type 1 collagen (NTX), and C-terminal cross-linking telopeptide of type 1 collagen (βCTX) decreased significantly in the intermittent ART group, whereas RANKL and the RANKL:osteoprotegerin (OPG) ratio increased (all p≤0.002 at month 4 and month 12). Increases in bALP, osteocalcin, P1NP, NTX, and βCTX at month 4 predicted decrease in hip BMD at month 12, while increases in RANKL and the RANKL:OPG ratio at month 4 predicted increase in hip and spine BMD at month 12. This study has shown that compared with continuous ART, interruption of ART results in a reduction in markers of bone turnover and increase in BMD at hip and spine, and that early changes in markers of bone turnover predict BMD changes at 12 months.</p></abstract><kwd-group><kwd>HIV</kwd><kwd>bone mineral density</kwd><kwd>antiretroviral therapy</kwd><kwd>bone turnover marker</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID</funding-source><award-id>U01 AI068641 || AI</award-id></award-group><award-group><funding-source country="United States">National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID</funding-source><award-id>U01 AI046362 || AI</award-id></award-group><award-group><funding-source country="United States">National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID</funding-source><award-id>U01 AI042170 || AI</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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