Metabolic syndrome in HIV infected adults in Poland

Abstract

A b s t r a c tBackground: Metabolic syndrome (MS) is usually diagnosed based on the presence of abdominal obesity, elevated blood pressure (BP), elevated fasting plasma glucose, high serum triglycerides (TG), and low high-density lipoprotein (HDL) cholesterol levels. Whether HIV is associated with a higher prevalence of MS than in the general population remains unclear. Aim:The aim of the study was to determine the incidence of MS in the population of HIV-infected adults and its association with clinical, virological, and biochemical features. Methods:Two hundred and seventy HIV-infected Caucasian adult patients were enrolled in the study and evaluated based on clinical records in the years 2013-2015.Results: Metabolic syndrome was diagnosed in 60 of 270 (22%) patients, 47 (24%) males and 13 (17%) females, mostly (72%) aged above 40 years. The percentage of patients with diagnosed MS in specific age groups in comparison to the general Polish population for females aged < 40 years was 7% vs. 4%, and males in the same age -18% vs. 9%, for females aged 40-59 years -47% vs. 24.4%, and males -33% vs. 28.3%. Particular components of MS in the MS population were found as follows: body mass index > 30 kg/m 2 in 29%, waist circumference exceeding 94 cm in men and 80 cm in woman -87.5%, TG ≥ 150 mg/dL -82%, HDL cholesterol < 40/50 mg/dL (males/females) -42%, systolic/diastolic BP ≥ 130 mmHg/≥ 85 mmHg -83%, and fasting glucose > 100 mg/dL -42%. In stepwise multivariate logistic regression analysis, age (odds ratio [OR] 1.052, 95% confidence interval [CI] 1.018-1.088, p = 0.003) and nadir CD4 < 350 cells/mm 3 (OR 3.576, 95% CI 1.035-12.355, p = 0.04) were associated with MS. Patients with MS compared with those without this disorder had low, intermediate, high, and very high cardiovascular risk in 10% vs. 23%, 73% vs. 70%, 7% vs. 5%, and 10% vs. 2%, respectively (p = 0.006). Conclusions:Prevalence of MS in the HIV-infected population is higher than in the general Polish population. Age and low nadir CD4 were found to be associated with MS.

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

“…However, pieces of literature suggested as MS emergence is mostly linked with the interplay of various factors; while several studies revealed the existed direct association of MS with the individual-based factors [4,14,[21][22][23][24][25][26][27][28][29][30][31]. Inconsistently, some other studies also restated equivocally the explicit effects of all a ranges of the above factors with the incidence of the syndrome [4,14,15,18,32].…”

“…Metabolic syndrome (MS) is the risk markers of NCDs, usually diagnosed based on the following medical conditions: abdominal obesity, elevated blood pressure (BP), elevated fasting plasma glucose, high serum triglycerides (TG), and low high-density lipoprotein (HDL) cholesterol levels [4,[14][15][16][17]].…”

“…In the sub-Saharan Africa (SSA), the prevalence of MS is not well established [4,18]. Adults with this problem will have a twofold as likely to die from and are three times as likely to have cardiovascular diseases (CVDs) and a five-fold greater risk of developing type 2 diabetes (T2DM) [2,7,11,14,19]. In this backdrop and its higher attendant economic and health system consequences of the identification and monitoring of comorbid health risks of HIV and ART [2,20], MS at present is a global public health issue [2], prominently in the SSA region and Ethiopia, the epicenter of HIV infection [2,11].…”

The role of sociocultural contexts in forming adult HIV-patients’ behavior towards the prevention of metabolic syndrome: A descriptive phenomenological study

“…Nevertheless, the increasing survival, in addition to HIV associated disorders, non-AIDS comorbidities are important factors that negatively affect the mortality rates of PLWHs(8-10), and metabolic syndrome (MS) is one of those comorbidities. It is usually defined as a complex of the diseases comprises abdominal fat, increased blood pressure, dyslipidemia or fat redistribution and or elevated blood sugar (3,(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

“…Subsequently, the PLWHs have shown better prognosis, decreased HIV transmission and improved survival (7,8).Nevertheless, the increasing survival, in addition to HIV associated disorders, non-AIDS comorbidities are important factors that negatively affect the mortality rates of PLWHs(8-10), and metabolic syndrome (MS) is one of those comorbidities. It is usually defined as a complex of the diseases comprises abdominal fat, increased blood pressure, dyslipidemia or fat redistribution and or elevated blood sugar (3,(11)(12)(13)(14)(15)(16)(17)(18)(19).Incontestably, adult with MS will have a twofold as likely to die from and three times as likely to have acquired cardiovascular disease(CVDs) (i.e. 17.7 million cause of deaths, or 45% of all NCD deaths contributor) (20) and a five-fold greater risk of developing diabetes mellitus (DM)(i.e 1.6 million causes of mortality) (21, 22), compared with people without the syndrome, and they are among the four most common and the leading causes of Non-Communicable Diseases (NCDs) related deaths (3,13).Implicated the significance of the shift of paradigm to prevent the incidence of NCDs at least in these vulnerable segments of the populations through promoting the PLWHs behavior towards the lifestyle factors than treating them with additional drugs.…”