Metabolic syndrome in HIV-infected patients receiving antiretroviral therapy in Latin America

Alvarez, C; Salazar, R; Galindez, J; Rangel, F; CastaÃ±eda, ML; Lopardo, G; Cuhna, CA; Roldan, Y; Sussman, O; Gutierrez, G; Cure-Bolt, N; Seas, C; Carcamo, C; Castrillo, M

doi:10.1590/s1413-86702010000300010

Cited by 30 publications

(48 citation statements)

References 18 publications

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“…This result was also found by other investigations. 5,13,20,22 The main limitation of this study relates to the distribution of MS defining criteria that may have been underestimated through the use of secondary data. The absence of information in medical records impeded the classification of individuals that had two defining conditions for metabolic syndrome and who did not have information on seric levels of HDL or triglycerides.…”

Section: ■ Discussionmentioning

confidence: 99%

“…Previous studies on the prevalence of MS in HIV infected individuals, carried out in Brazil, found prevalence levels that varied between 15% and 36%. [20][21][22][23] Studies performed in Brazil on non HIV infected individuals found a prevalence of MS varying from 25.4% to 30%. [24][25][26] Differences between the studied population groups and diagnostic criteria make it difficult to compare these reports.…”

Section: ■ Discussionmentioning

confidence: 99%

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Anthropometric Risk Factors for Metabolic Syndrome in HIV patients

Leal¹,

Fausto²,

Carneiro³

2016

Medical Express

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OBJECTIVE:Metabolic syndrome, which affects the general population in epidemic proportions, is associated with a set of cardiovascular disease risk factors. The aims of this cross-sectional study were to determine the prevalence and investigate the risk factors associated with metabolic syndrome in outpatients living with HIV/AIDS using anthropometric and clinical evaluations. METHOD:The study was carried out on 253 HIV infected outpatients. Metabolic syndrome was classified according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATPIII) and the International Diabetes Federation (IDF) criteria. Logistic regression was used to identify factors associated with the metabolic syndrome. RESULTS: The prevalence of metabolic syndrome varied from 19.4% to 26.4%, according to the criterion used. The factors associated with it in the two classifications used, when adjusted by sex and BMI, were age (≥ 40years) and subscapular skinfold (> 12 mm). In the final model, using the NCEP/ATPIII criterion the risk factors associated with metabolic syndrome were age ≥ 40 years (OR = 3.18; CI95% = 1.42; 7.14) and subscapular skinfold > 12 mm (OR = 2.85, CI95% = 1.13; 7.17). In the final model, using the IDF criterion the risk factors associated with metabolic syndrome were age (OR = 3.38, CI95% = 1.61; 7.10) and subscapular skinfold > 12 mm (OR = 4.37, CI95% = 1.84; 10.39). CONCLUSION: In clinical practice, the regular monitoring of subscapular skinfold can help in the identification of HIV infected individuals in risk of MS.

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Section: ■ Discussionmentioning

confidence: 99%

Section: ■ Discussionmentioning

confidence: 99%

Anthropometric Risk Factors for Metabolic Syndrome in HIV patients

Leal¹,

Fausto²,

Carneiro³

2016

Medical Express

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“…The high prevalence of dyslipidemia in HIV-infected individuals with metabolic syndrome has been supported in multiple other studies. 1,3,4,[20][21][22] This is not surprising since low HDL and high triglycerides are metabolic abnormalities that have long been associated with HIV disease prior to the use of highly active antiretroviral therapy. 23,24 Our study shows that, consistent with prior research, low HDL is associated with an increased risk of mortality, although after adjusting for age, heroin use, albumin, BMI, and HIV viral load, the association was not significant at the p < 0.05 level.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have reported a high prevalence of metabolic syndrome in HIV-infected populations from different countries, ranging between 18-52.2%. [1][2][3][4][5][6] In HIVnegative populations, metabolic syndrome has been shown to increase the risk of cardiovascular events, cardiovascular mortality, and all-cause mortality. [7][8][9][10][11][12][13] The potential health impact of metabolic syndrome on HIV-infected populations is not as clearly understood.…”

Section: Introductionmentioning

confidence: 99%

Metabolic Syndrome Predicts All-Cause Mortality in Persons with Human Immunodeficiency Virus

Jarrett

Wanke

Ruthazer

et al. 2013

AIDS Patient Care and STDs

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We examined the association between metabolic syndrome (MS) and its individual defining criteria on all-cause mortality in human immunodeficiency virus (HIV)-infected persons. We used data from 567 HIV-infected participants of the Nutrition for Healthy Living study with study visits between 9/1/2000 and 1/31/2004 and determined mortality through 12/31/2006. MS was defined using modified National Cholesterol Education Program guidelines. Cox proportional hazards for all-cause mortality were estimated for baseline MS status and for its individual defining criteria. There were 83 deaths with median follow-up of 63 months. Baseline characteristics associated with increased risk of mortality were: older age in years (univariate hazard ratio [HR] 1.04, p<0.01), current smoking (HR 1.99, p=0.02), current heroin use (HR 1.97, p=0.02), living in poverty (HR 2.0, p<0.01), higher mean HIV viral load (HR 1.81, p<0.01), and having a BMI <18 (HR 5.84, p<0.01). For MS and its criteria, only low HDL was associated with increased risk of mortality on univariate analysis (HR 1.84, p=0.01). However, metabolic syndrome (adjusted HR 2.31, p=0.02) and high triglycerides (adjusted HR 3.97, p<0.01) were significantly associated with mortality beyond 36 months follow-up. MS, low HDL, and high triglycerides are associated with an increased risk of mortality in HIV-infected individuals.

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“…Some studies show no association between the use of ART and risk of CVD or cerebrovascular disease (166) , while others show a positive association for PI (30,118,167,168) . Research has shown that between 5 and 31 % of patients with HIV/AIDS are at risk for cardiovascular events (73,169,170) , and, similar to the general population, patients with the metabolic syndrome have a greater risk than those without (170) . Variations in observed risk could be explained by differences in the risk factors of the study population.…”

Section: Cvdmentioning

confidence: 99%

Nutrition and the HIV-associated lipodystrophy syndrome

Loonam

Mullen

2012

Nutr. Res. Rev.

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HIV-associated lipodystrophy syndrome (HALS), comprising metabolic and morphological alterations, is a known side effect of highly active antiretroviral therapy (HAART). Evidence for the role of nutrition in the management of the systemic parameters of HALS is currently limited. In the present paper we review the current knowledge base surrounding HALS, focusing particularly on the role of nutrition in mitigating the systemic parameters of the syndrome. Reported prevalence of HALS was found to vary from 9 to 83 % due to lack of a standardised definition, as well as variations in assessment methods and in the study population used. HALS is associated with both morphological (lipoatrophy, lipohypertrophy) and metabolic (dyslipidaemia, glucose intolerance, diabetes, hypertension, endothelial dysfunction and atherosclerosis) alterations, which may occur singly or in combination, and are associated with an increased risk of CVD. HAART-induced adipocyte inflammation, oxidative stress and macrophage infiltration, as well as altered adipocyte function and mitochondrial toxicity, have been shown to be central to the development of HALS. The adipocyte, therefore, represents a plausible target for treatment. Pharmacological and surgical treatment interventions have shown effect. However, their use is associated with numerous adverse effects and complications. Targeted lifestyle interventions may provide a useful alternative for managing HALS owing to their safety and tolerability. A Mediterranean-style diet has been found to be effective in improving the systemic parameters of HALS. Furthermore, the effects of n-3 PUFA supplementation are encouraging and future randomised controlled trials investigating the beneficial effects of n-3 PUFA in HALS are justified.

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Metabolic syndrome in HIV-infected patients receiving antiretroviral therapy in Latin America

Cited by 30 publications

References 18 publications

Anthropometric Risk Factors for Metabolic Syndrome in HIV patients

Anthropometric Risk Factors for Metabolic Syndrome in HIV patients

Metabolic Syndrome Predicts All-Cause Mortality in Persons with Human Immunodeficiency Virus

Nutrition and the HIV-associated lipodystrophy syndrome

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