Metabolic syndrome and population attributable risk among HIV/AIDS patients: comparison between NCEP-ATPIII, IDF and AHA/NHLBI definitions

Abstract

BackgroundMetabolic Syndrome (MetS) is based on the same individual components, but has received several amendments to the original definition. In this study, we verified the prevalence of metabolic syndrome according to different criteria, and the impact of each component on the diagnostic.MethodsThis cross-sectional study enrolled HIV infected patients from a HIV/AIDS reference Center in southern Brazil. Metabolic syndrome was identified according to the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII), the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) criteria, and using a standardized questionnaire and blood testing.ResultsA sample of 1240, out of 1295, HIV-infected patients was enrolled. Males were on average older, more educated, and had shorter time since the HIV diagnosis. The population attributable risk (PAR) for waist circumference explained 80% of the prevalence among men and women (AHA/NHLBI criteria). Triglycerides had the highest impact on prevalence of metabolic syndrome according to all criteria, independently of age, skin color and HAART use, among men.ConclusionsIn this large sample of HIV infected patients, the overall prevalence of metabolic syndrome, under either classification, was noticeable and the AHA/NHLBI definition accounted for the highest prevalence.

Lipodystrophy syndrome in HIV-infected patients – a cohort study in Lower Silesia, Poland

“…Mercie et al observed significantly older age of patients diagnosed with LS and noticeably lower BMI and CD4+ T-lymphocyte count in comparison with cART-using patients with no LS [25]. In the majority of findings, LS features are found in patients treated with antiretroviral therapy [6,7].…”

“…In their research, patients on antiretroviral therapy were older and had significantly higher BMI. Lipodystrophy and lipohypertrophy were correlated to age and BMI, whereas lipoatrophy was only correlated to BMI, without any significant influence of age [6]. Mercie et al observed significantly older age of patients diagnosed with LS and noticeably lower BMI and CD4+ T-lymphocyte count in comparison with cART-using patients with no LS [25].…”

“…These observations are consistent with most publications. The correlation between the time of HIV infection, its severity, patients' age and prevalence and severity of dystrophic changes is undisputable [6,18,27]. Mercie et al discovered a visibly lower CD4+ T-lymphocyte count in a group of significantly older patients with LS than in a no-LS group [25].…”

“…Since the introduction of antiretroviral treatment, PIs has been the first class whose side effects have been described as lipodystrophy syndrome. The influence of this class of medications, specific drugs and time of PI treatment on LS development and severity have been widely described [1,2,6,11,14,27].…”

“…However, further studies also discovered the influence of other antiretroviral drugs, mostly nucleoside reverse transcriptase inhibitors (NRTIs), and of HIV infection itself [6][7][8][9][10][11]. Most authors emphasize the significant role of adipose tissue in pathogenesis of this condition; the role of the immune system, proinflammatory cytokines such as TNF-α and interleukin (IL)-6 and genetic predisposition are also mentioned [2,3,8,12,13].…”