Comparing the Ability of Anthropometric Indicators in Identifying Metabolic Syndrome in HIV Patients

Abstract

BackgroundHighly active antiretroviral therapy (HAART) can cause side effects in HIV patients, as the metabolic syndrome. Early identification of risk for development of cardiovascular diseases using available reliable and practical methods is fundamental. On this basis, the aim of this study was to compare the effectiveness of anthropometric indicators to identify metabolic syndrome in HIV patients on HAART.MethodsIt is a cross-sectional study. A number of 280 stable HIV patients were studied. It measured weight, height, waist circumference (WC), hip circumference (HP), thigh circumference (TC) and calculated body mass index (BMI), body adiposity index (BAI), waist to hip ratio (WHR) and waist to thigh ratio (WTR). There was also a performance of biochemical tests of lipid profile and fasting glucose. Systemic blood pressure was measured. The criteria proposed by the National Cholesterol Education Program III (NCEP-ATP III) to metabolic syndrome classification was used. Individuals were divided in groups with or without metabolic alterations and their anthropometric indicators were compared. Receiver operating characteristic (ROC) curves were designed for each anthropometric indicator using the metabolic syndrome classification to identify sensitivity and specificity.ResultsWC was a good tool to identify each metabolic disorder separately: total cholesterol (only females, p<0.05), triglycerides (only males, p<0.001), HDL cholesterol (p<0.05), LDL cholesterol (p<005) and fasting glycemic (p<005). WC also showed the best performance to identify metabolic syndrome in both genders (areas under the curve (AUCs): 0.79 and 0.76 for male and female, respectively), while BAI proved to be an inadequate indicator (AUCs: 0.63 and 0.67 for males and females), respectively, in this population.ConclusionsThe central adiposity measure (WC) had the best performance to identify metabolic syndrome, and it is a convenient, cheap and reliable tool that can be used in clinical practice routinely to prevent cardiovascular complications in HIV patients.

Serum lipid profiles of patients taking efavirenz based antiretroviral regimen compared to ritonavir-boosted atazanavir with an optimized back ground at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

“…Waist circumference also signi cantly associated with TC among female participants in ATV/r-treated group. In agreement with these results, a study done by Beraldo et al [30] reported signi cant association between waist circumference and TC levels.…”

Redistribuição de gordura corporal e alterações no metabolismo de lipídeos e glicose em pessoas vivendo com HIV/AIDS

“…The AC assesses the deposition of central fat in the abdominal region and abdominal obesity is a greater risk cardiovascular factor than overall obesity 29 . A study by Freitas and colleagues, the prevalence of abdominal lipodystrophy among women also reached the 80% range, double the prevalence of males, corroborating the present study 27 .…”

Anthropometric measures as indicators of the nutritional status of people living with HIV

“…However, the authors encourage the routine use of indicators such as WC, since they have a better predictive capacity for cardiometabolic risk in patients with HIV infection (k = 0.20, p= 0.001) 34 . Beraldo et al 35 also reinforce the use of WC in the evaluation of PLH, since this parameter evaluates fat deposition in the abdominal region, because abdominal visceral obesity is a more serious cardiovascular risk factor than general obesity, and is usually evaluated by IMC 35 .…”