Prevalence and predictors of metabolic syndrome among people living with human immunodeficiency virus (PLWHIV)

Abstract

BackgroundUse of combination antiretroviral therapy (cART) has led to significant reductions in morbidity and mortality. However, there is a growing concern about metabolic syndromes (MS), among patients receiving cART. Despite this fact, there is limited evidence for the prevalence of the MS among HIV-infected persons receiving cART in developing countries, particularly Ethiopia.ObjectiveTo determine the prevalence and predictors of MS among people living with HIV/AIDS in Jimma health centre, Jimma Zone south west Ethiopia.MethodsA cross-sectional study was conducted on people living with HIV/AIDS (PLWHA) in Jimma health centre that fulfilled the inclusion criteria. Data on demographic and anthropometric characteristics were collected using World health organization (WHO) stepwise approach. Fasting blood glucose and lipid profile was measured. The Third Report of National Cholesterol Education Program-adult treatment panel III (NCEP-ATP III)-2001, the International Diabetes Federation (IDF)-2005 and the Joint interim statement-2009 (JIS) criteria were used to define MS. Data were analyzed using statistical software package (SPSS) version 20.0. Logistic regression analysis was done to identify predictors of MS and predictors with p value < 0.05 were used to declare statistical significance.ResultsOf 268 HIV-infected participants included in the analysis, 211 (78.7%) were women. The mean age of the participants was 39.32 ± 10.626 years. Using the NCEP-ATP III criteria, the prevalence of MS was found to be 23.5% (63 patients). While it was 20.5% (55 patients) and 27.6% (74 patients) with IDF and JIS criteria respectively. Enrollment in formal education resulted in 75% increment in the odds of MS (AOR = 0.25, 95% CI [0.072–0.879]). The odds of MS in patients with body mass index > 25 kg/m2 was elevated to 13.4 times (AOR = 13.39, 95% CI [3.943–45.525]) and exposure to D-drugs was attributed to 59% increment in the odds of MS (AOR = 1.59, 95% CI [0.58–4.56]), although the finding lacks statistical significance.ConclusionsMetabolic syndromes was relatively common to the study population. Hence, promoting health education and monitoring patient’s clinical and laboratory parameters at every visit and taking appropriate measure is ideal.

Metabolic Syndrome in People Living with HIV in Lome (Togo): Epidemiological Aspects and Associated Factors

“…This result is consistent in studies of PLWHIV reflecting the economic impact of HIV infection on the young working population [11] [14] [15]. The female predominance highlighted in our study is also consistent in the literature reflecting the greater susceptibility of women to HIV infection than men [16] [17].…”

Predictors of metabolic syndrome among people living with HIV in the Gedeo-Zone, Southern-Ethiopia: an unmatched case-control study

“…Moreover, with regards of hypertension and or elevated blood pressure measures, correlating with our study result, even if other hand several other literatures from developing countries were indicated in the reverse, and prevails that these variables were identified as a common traits and a significant predictor of MS among those PLHIVs [45,65,66] [42]. As regards, as Bosho, et al (2018) [42] describes, more of the raised BP measure was the most common feature of abnormalities MS, than impaired fasting plasma glucose commonly seen among PLHIVs. All in all, though our result supported that only diabetes predicts MS, but this doesn't guarantee to conclude that it is the only predictors.…”

“…As per the self-reported lifestyle associated factors, although the following factors such as alcohol consumption, smoking habits, 'Khat chewing habits, frequency of consumption of fruit and vegetable, and fat and oil showed no significant association with the presence of MS; however, physical activity was found to be indirect predictors of MS. Studies with this respects are inconsistent with some reporting significant association for smoking habits [41,50,60], alcohol consumption [41,50,61], and physical activity [41,62] while others and results of the same study reported no association for 'Khat chewing habits [42], alcohol use [35,42], physical activity [35,42,61], smoking habits [15,35,42,61,62]. This might be partly explained due to the lower number of individuals grouped under each category that might affect the analysis.…”

“…While few studies have agreeable output on the second line regimen, (primarily the protease inhibitors (PI)) as a predictor for the incidence of MS [21,35,51], however, few other studies were disclosed that the first-line ART regimen, mainly of the Nucleoside Reverse Transcriptase Inhibitors (NRTIs) and the Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) as predictor of MS incidence [15,26,35,42,51]. In relation to this regimen, studies were further revealed that in patients using Stavudine (d4T) [42,52,53] alone, and NRTI as a whole [42,54] studies have shown that this regimen has no association with the incidence of the syndrome. Overall, the finding shown the existence of contradicted knowledge regarding the typical influences of specific ART regimen with the incidence of MS arose from the drug combination given together as one time dose .…”

“…Overall, the finding shown the existence of contradicted knowledge regarding the typical influences of specific ART regimen with the incidence of MS arose from the drug combination given together as one time dose . Also, it might also dictate the direct impact of exposure to any ART regimens on lipid metabolism, endothelial and adipocyte cell function, and mitochondria dysfunction [42,58], along with the link of the treatment with the incidences of each traits [42,59] of MS, might be the possible reason for the differences encountered. This implicates to initiates further studies with strong design to differentiate the specific effects each drug regimen with MS incidence.…”