Metabolically Healthy or Metabolically Unhealthy Obese HIV-Infected Patients: Mostly a Matter of Age?

Abstract

Background: Life expectancy of HIV-infected patients has increased with antiretroviral treatment (ART). Chronic diseases associated with aging, including metabolic and cardiovascular diseases are becoming more prevalent in this population. We aimed to evaluate the association of obesity and aging with cardiometabolic comorbidities and metabolic health status among patients with HIV infection.Methods: We evaluated 580 HIV-1 infected patients (71.7% male, mean age of 47.7 ± 11.5 years). We analyzed the association of age and obesity (defined by and by central obesity) with gender, duration of HIV infection, and ART, anthropometric parameters, cardiometabolic comorbidities, Framingham risk score (FRS), blood pressure, lipid profile, uric acid, liver biochemical tests, and glycemic profile. Furthermore, we analyzed the above-mentioned associations according to the category and central obesity into the metabolically healthy (MH) and unhealthy (MUH) categories. To evaluate the association of anthropometric parameters with cardiometabolic comorbidities, we performed unadjusted and adjusted logistic regression models.Results: The prevalence of excessive weight and cardiometabolic comorbidities increased with age. Patients with normal weight were younger and there was a higher proportion of female patients in the obesity group. The prevalence of hypertension and metabolic syndrome were higher among patients who were overweight or with obesity. The FRS was higher among patients with obesity. The proportion of MUH patients was higher among patients with excessive weight and central obesity. MUH patients had more cardiometabolic comorbidities and a higher FRS. In the normal weight group, MUH patients were older, and in the obesity group they were more likely to be male. The anthropometric parameter most associated with metabolic syndrome was waist circumference and that most associated with hypertension was waist-to-height ratio. The anthropometric parameter most associated with diabetes and FRS was waist-to-hip ratio.Conclusion: Patients with HIV present a high prevalence of obesity and related comorbidities. Ageing significantly contributes to metabolic dysfunction in this population. The proportion of MUH patients is higher among groups with excessive weight and central obesity, with those patients presenting a higher cardiovascular risk. Our results highlight the importance of evaluating and addressing obesity in patients with HIV, as well as metabolic comorbidities and cardiovascular risk.

Metabolic syndrome in people with HIV from Guatemala: analysis of components and risk factors

“…39 Other studies in PWH have also determined that hyperuricemia is significantly associated with progressing from normal to obese weight and being diagnosed with high blood pressure, dyslipidemia and high fasting glucose. 40,41 While the exact mechanism linking hyperuricemia and metabolic syndrome is unknown, both conditions are related with meat-based, high-fructose and low nutrient diets. 42 These types of diets have been found to be highly prevalent in young adults from urbanized areas in Guatemala 43 and could also be a social risk factor for PWH.…”

“…A total of 844 participants were included in this analysis. Median age was 39 years [interquartile rage (IQR) [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48], 479 were male (56.8%), and 139 (16.5%) selfidentified with indigenous ethnicity. Primary education or below was reported by 459 participants (54.3%) and 70.8% were urban dwellers (598).…”

Emerging Viral Infections and the Potential Impact on Hypertension, Cardiovascular Disease, and Kidney Disease

“…94 In a study of 580 patients with HIV, the prevalence of MS and hypertension were higher among patients with obesity. 95 Other associations for the development of hypertension in people with HIV include, but are not limited to, older age, male gender, Black race, and chronic kidney disease. [96][97][98]…”

Η Επίδραση Της Έκθεσης Σε Εικόνες Προτύπων Ελκυστικών Ανθρώπων Στην Εικόνα Σώματος Των Μεσηλίκων

“…Ο Rosenberg (1965) (Neymotin & Nemzer, 2014. Webster & Tiggemann, 2003 (Neves, Guerreiro, Carvalho, Serrão, Sarmento, & Freitas, 2018. Tiggemann, 2004 (Αrbour & Ginis, 2005.…”