Lipodystrophy, metabolic syndrome and clustering of metabolic syndrome components in 1886 HIV-infected individuals from Brazil
D. Miranda-Filho1, T. Gelenske2, É. Carvalho2, P.S. Araújo3, M.D.F.P.M.d. Albuquerque3, R.A.d.A. Ximenes4, H.R. Lacerda4, F. Bandeira4
1University of Pernambuco, Internal Medicine, Recife, Brazil, 2Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil, 3Fiocruz Centro de Pesquisas Aggeu Magalhães, Recife, Brazil, 4University of Pernambuco, Recife, Brazil
Background: HAART changed the morbidity of patients with HIV/AIDS, raising metabolic disorders in this particular population. This study aimed to estimate prevalence of lipodystrophy and metabolic syndrome (MS) among HIV-infected persons; identify more frequent defining components of MS; the most common clustering of these variables and characterize this population according to the number of components defining MS.
Methods: This is a cross-sectional study with HIV/AIDS patients in Recife, Brazil, between June/2007 and October/2009. Lipodystrophy was defined by self-reported specific questionnaire. MS was defined according NCEP/ATPIII modified/2005. For analysis, we used chi-square test and student test with statistical significance if p < 0.05.
Results: From 1886 patients included, 61.7% were men. Prevalence of lipodystrophy among 1471 users of HAART was 55.4% and there was no difference between sexes. The overall prevalence of MS in 1583 patients was 29.8%, being higher among women(34.8%) than men(26.7%, p< 0.001). There was 187(11.8%) individuals with no defining criterion, 473 (29.9%) with one criterion, 451(28.5%) with two, 304(19.2%) with three, 135(8.5%) with four and 33(2.1%) with all criteria. In those with MS, the frequency of defining components was: hypertriglyceridemia(87.7%), low HDL-c(84.5%), hypertension(80.7%), increased waist circumference(46.4%) and blood glucose≥100mg/dl(43.2%). The most frequent clustering of components was hypertriglyceridemia, low HDL-c and hypertension. The ratio triglycerides/HDL-C was higher in individuals with MS(7.7±6.6) than in individuals without MS (4±3.7, p < 0.001).
Conclusions: Prevalence of lipodystrophy was high and consistent with other studies. Prevalence of MS was similar to general population, although a high proportion of individuals had presented at least one criterion for MS(88.2%). This could reflect increase of this disorder in future. The ratio triglycerides/HDL-C higher in patients with MS suggests insulin resistance in this population. This study highlights the high prevalence of metabolic disorders known to be associated with increased risk of cardiovascular events in individuals with HIV in northeastern Brazil.
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