Prevalence and risk factors of high cholesterol and triglycerides among people with HIV in Texas

Abstract

Background People with HIV (PWH) commonly have elevated cholesterol and triglycerides levels that have been linked to medications. However, healthy behaviors including lifestyle changes can lower high cholesterol (CHOL) or high triglycerides (TG), thereby reducing individual risk for cardiovascular diseases. This study aimed to determine the prevalence and risk factors associated with high CHOL or TG among PWH in Texas. Methods Cross-sectional data of 981 PWH from the 2015–2017 Texas and Houston Medical Monitoring Projects were examined. High CHOL or TG was identified by medical chart diagnosis, CHOL or TG medication use, or most recent fasting lab ≥ 200 mg/dl (total CHOL) or ≥ 150 mg/dl (TG). High CHOL or TG associations with sociodemographic and clinical characteristics were assessed using Rao-Scott chi-square tests. Prevalence of high CHOL or TG development was calculated using multivariable logistic regression model. Results High CHOL or TG prevalence was 41% with participants being mostly male (73%), ≥ 40 years (68%), with overweight (31%) or obesity (28%), and virally suppressed (62%). Compared with PWH < 40 years of age, PWH in their 40s, 50s, and ≥ 60s were 57%, 64%, and 62% more likely to have high CHOL or TG, respectively. Participants with overweight and obesity were 41% and 30% more likely to have high CHOL or TG than those with normal weight (BMI: 18.5– < 25), respectively. Conclusion Since high CHOL and TG are modifiable CVD risk factors, increased education and lifestyle modification interventions are warranted to prevent the development of high CHOL or TG among PWH.

High IL-1β and IL-18 Levels Associate with Gut Barrier Disruption and Monocyte Activation During Chronic SIV Infection with Long-Term Suppressive Antiretroviral Therapy

“…High cholesterol and elevated TG may contribute to atherogenesis and CVD burden among PWH. Although we did not find significant increases in blood cholesterol levels during the 1-year SIV+ART period in our study, our findings of steady increase in TG levels from 5 months onwards is in concordance with the decreased clearance of triglycerides and increase in disease burden observed among PWH with several years of suppressed viral infection [31,52]. Further, our results showing increased glycolysis in PBMCs during chronic SIV infection with long-term ART reflects the elevated glycolysis in HIV-infected CD4 T cells, monocytes and macrophages to generate metabolites supporting synthesis of lipids, nucleotides and viral proteins necessary for HIV replication and latency [53,54].…”

“…Studies have shown a strong association between high triglyceride (TG) levels and increased risk of CVD events like heart attack and stroke in HIV-infected individuals [31]. This is likely driven by chronic HIV-associated inflammation and the metabolic effects of certain antiretroviral drugs [32].…”

Epidemiology of obesity among people with HIV

“…However, they also found that other indices of vascular compliance, such as carotid-femoral and carotid-radial pulse wave velocity, did not significantly differ between PWH who were underweight vs. overweight [34]. Additionally, using cross-sectional data from a US-based cohort (73% male and 44% Black), Buendia et al found that participants with overweight and obesity were at higher odds of having high total cholesterol or triglycerides (41% and 30%, respectively) [35]. Further, a meta-analysis of 10 studies with PWH from the US, Canada, France, Italy, China, and Japan demonstrated that BMI was associated with nonalcoholic fatty liver disease (NAFLD) [mean difference (MD) = 2.92, 95% CI: 2.14–3.70] and hepatic fibrosis (MD = 1.38, 95% CI: 0.04–2.71) [36].…”

“…Given the high prevalence of obesity among PWH on ART globally [2] and the myriad of metabolic complications associated with obesity [32,34,35], strong imperatives exist to better understand the factors contributing to and strategies to mitigate obesity risk among PWH. While ART is currently the standard of care for PWH [20], additional measures (pharmacologic and/or nonpharmacological) may need to be implemented at the time of ART initiation to prevent weight gain and/or treat prevalent obesity among PWH.…”

Prevalence of Dyslipidemia and Its Determinants Among the Adult Population of the Jazan Region

“…13 It has been demonstrated that some groups, such as those who are overweight (ie, body mass index [BMI] of 25-30 kg/m2) or obese (BMI of 30 kg/m2), have a family history of high cholesterol or triglycerides, are over 40 years of age, and/or who smoke have comparatively higher odds of developing high cholesterol or triglycerides. 14 Other risk factors may include unhealthy lifestyle habits (eg, a diet high in saturated fats, lack of physical activity, and stress), other medical conditions (eg, chronic kidney disease and hypothyroidism), medications (eg, steroids and immunosuppressive medicines), and gender. According to the National Heart, Lung, and Blood Institute, men between the ages of 20 and 39 years have higher cholesterol levels than women.…”