Metabolic Syndrome: A Real Threat for HIV-Positive Patients?

Bonfanti, Paolo; Ricci, Elena; Socio, Giuseppe Vittorio De; Zeme, D; Carradori, Silvia; Penco, Giovanni; Parruti, Giustino; Grosso, Carmela; Madeddu, Giordano; Vichi, Francesca; Bini, Teresa; Martinelli, Canio; Melzi, Sara; Quirino, Tiziana

doi:10.1097/01.qai.0000219775.20174.2d

Cited by 27 publications

(32 citation statements)

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“…The effect of current treatment on MS was significant only for nonthymidine NRTIs. Our findings are in part consistent with those of previous studies that demonstrated an association between both current and previous PI exposure and MS occurrence [2,5,8,10]. One study demonstrated an association between current stavudine (d4T) and MS, which remained after adjustment for BMI and age [2].…”

supporting

confidence: 82%

“…The influence of highly active antiretroviral therapy (HAART) on the development of MS is still a matter of controversy, but a higher prevalence of MS in HIV-infected patients on HAART compared with the background population has been proposed [7,9]. An increased prevalence of MS has also been demonstrated among patients currently or previously treated with protease inhibitors (PIs) [2,5,8,10].…”

Section: Introductionmentioning

confidence: 98%

“…An Correspondence: Dr Birgitte R. Hansen, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegaard Allé 30, DK-2650 Hvidovre, Denmark. Tel: 1 4536322108; fax: 1 4536323797; e-mail: brhansen@dadlnet.dk DOI: 10.1111/j.1468-1293.2009.00697.x HIV Medicine (2009 r 2009 British HIV Association 378 increased prevalence of MS has also been demonstrated among patients currently or previously treated with protease inhibitors (PIs) [2,5,8,10]. Multiple studies have documented metabolic and morphological complications in HIV-infected patients on HAART.…”

Section: Introductionmentioning

confidence: 99%

“…Predictors for the development of MS include excess weight, physical inactivity and aging, and the syndrome is closely associated with insulin resistance. Since its identification, the epidemiology and consequences of the syndrome have been studied intensively.In HIV-infected patients, the prevalence of MS has been reported to be 16-24% [2][3][4][5][6][7][8][9]. However, selection bias and small study populations have hampered these prevalence studies.…”

mentioning

confidence: 99%

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The prevalence of metabolic syndrome in Danish patients with HIV infection: the effect of antiretroviral therapy

et al. 2009

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The prevalence of metabolic syndrome (MS) in HIV-infected patients on highly active antiretroviral therapy (HAART) is a subject of debate. We investigated the prevalence of MS in a cohort of Danish HIV-infected patients and estimated the effect of the various classes of antiretroviral therapies on the prevalence of MS and its components. MethodsA cross-sectional study was performed in which data were obtained from fasting blood tests, anthropometry, an interview questionnaire and whole-body dual-energy X-ray absorptiometry (DEXA) scans. MS was defined using the National Cholesterol Education Programme (NCEP) Adult Treatment Panel (ATP) III diagnostic criteria. ResultsFive hundred and sixty-six patients were included in the study, of whom 27% were diagnosed with MS. In univariate analysis, the duration of treatment with different drug classes was associated with the prevalence of MS. In multivariate analysis, no association was demonstrated between therapeutic duration or modality and the occurrence of MS. Current nonthymidine reverse transcriptase inhibitor (NRTI) and protease inhibitor (PI) therapies were both associated with increased plasma triglycerides (TG) [odds ratio (OR) 3.42, 95% confidence interval (CI) 1. and OR 1.96, respectively]. ConclusionsMS is prevalent in HIV-infected Danes. However, treatment with specific drug classes does not seem to confer an elevated risk for MS, other than the risk conferred by known acute effects on triglycerides.Keywords: highly active antiretroviral therapy, HIV-associated lipodystrophy syndrome, HIV infection, metabolic syndrome IntroductionThe concept of metabolic syndrome (MS), which specifies a cluster of interrelated risk factors for cardiovascular disease, was reintroduced by Reaven in 1988 [1]. Predictors for the development of MS include excess weight, physical inactivity and aging, and the syndrome is closely associated with insulin resistance. Since its identification, the epidemiology and consequences of the syndrome have been studied intensively.In HIV-infected patients, the prevalence of MS has been reported to be 16-24% [2][3][4][5][6][7][8][9]. However, selection bias and small study populations have hampered these prevalence studies. The influence of highly active antiretroviral therapy (HAART) on the development of MS is still a matter of controversy, but a higher prevalence of MS in HIV-infected patients on HAART compared with the background population has been proposed [7,9]. An Correspondence: Dr Birgitte R. Hansen, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegaard Allé 30, DK-2650 Hvidovre, Denmark. Tel: 1 4536322108; fax: 1 4536323797; e-mail: brhansen@dadlnet.dk DOI: 10.1111/j.1468-1293.2009.00697.x HIV Medicine (2009 r 2009 British HIV Association 378 increased prevalence of MS has also been demonstrated among patients currently or previously treated with protease inhibitors (PIs) [2,5,8,10]. Multiple studies have documented metabolic and morphological complications in HIV-infected patients on HAART. Antiretrovir...

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supporting

confidence: 82%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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The prevalence of metabolic syndrome in Danish patients with HIV infection: the effect of antiretroviral therapy

et al. 2009

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“…Bonfanti e cols. também observaram que a lipodistrofia foi mais comum entre pacientes com SM (54% versus 37%, p < 0,0001) (34). Possíveis explicações para essa diferença podem ser o menor tamanho desta amostra e a heterogeneidade destas populações.…”

Section: Diehl Et Alunclassified

Prevalência da lipodistrofia associada ao HIV em pacientes ambulatoriais brasileiros: relação com síndrome metabólica e fatores de risco cardiovascular

Diehl¹,

Dias²,

Paes³

et al. 2008

Arq Bras Endocrinol Metab

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RESUMOA lipodistrofia associada ao HIV (LAHIV) acomete 40% a 50% dos pacientes infectados pelo vírus, mas sua prevalência no Brasil é desconhecida. O objetivo deste trabalho foi avaliar a prevalência de LAHIV entre adultos brasileiros infectados, bem como sua relação com fatores de risco cardiovascular e sín-drome metabólica (SM). Foram avaliados 180 pacientes maiores de 18 anos, infectados por HIV, atendidos no Ambulatório de Infectologia da Universidade Estadual de Londrina. Por meio de entrevista e revisão de prontuário, foram avaliados dados antropométricos, pressão arterial, antecedentes mór-bidos pessoais e familiares, duração da infecção por HIV e da aids, drogas anti-retrovirais utilizadas, CD4+, carga viral, glicemia e perfil lipídico. A LAHIV foi definida como a presença de alterações corporais percebidas pelo próprio paciente e confirmadas ao exame clínico. A SM foi diagnosticada usando os critérios do Adult Treatment Panel III (NCEP-ATPIII), revistos e atualizados pela American Heart Association (AHA/NHLBI). A prevalência observada de LAHIV foi de 55%. Os pacientes com LAHIV apresentaram maior duração da infecção por HIV, da aids e do uso de anti-retrovirais. Na análise multivariada, estiveram independentemente associados ao risco de LAHIV: sexo feminino (p = 0,006) e duração da aids 8 anos (p < 0,001). Quanto aos critérios para SM, hipertensão foi detectada em 32%, baixo HDL-colesterol em 68%, hipertrigliceridemia em 55%, cintura aumentada em 17% e glicemia aumentada e/ou diabetes em 23% dos indivíduos. A cintura aumentada e a hipertrigliceridemia foram mais comuns em portadores de LAHIV. A SM foi identificada em 36% dos pacientes. Na análise multivariada, estiveram associados à SM: IMC 25 kg/m 2 (p < 0,001), história familiar de obesidade (p = 0,01), uso de indinavir (p = 0,001) e idade 40 anos no diagnóstico do HIV (p = 0,002). A LAHIV apresentou tendência a ser mais comum em portadores de SM (65% versus 50%, p = 0,051). A prevalência de LAHIV que se observou neste grupo (55%) foi similar à descrita em estudos prévios de outros países. A prevalência de SM nestes pacientes parece ser diferente da descrita em adultos brasileiros não-infectados pelo HIV. (Arq Bras Endocrinol Metab 2008; 52/4:658-667) Descritores: Síndrome da lipodistrofia associada ao HIV; Síndrome X metabólica; Infecções por HIV; Prevalência; Brasil.

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