Hiransuthikul Narin, Hiransuthikul Pornthip, Kanasook Yootana
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 2007 Jan;38(1):69-77.
Dyslipidemia is a common metabolic complication among HIV-infected patients who receive protease inhibitor (PI)-based antiretroviral therapy (ART). In order to assess the prevalence of lipid abnormalities and related factors, a cross-sectional analytic study of the lipid profiles of 170 Thai adult HIV-infected patients receiving PI-containing HAART who attended the HIV-clinic, King Chulalongkorn Memorial Hospital, Bangkok, Thailand between January and August 2005 was conducted. Studied subjects had a median age of 40 years with a median duration of taking PIs of 22.1 months. The mean serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), and triglyceride (TG) levels were 259.7, 43.7, 135.2, and 506.8 mg/dl, respectively, and the mean TC:HDL-c ratio = 6.4. According to the US National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) guidelines, high TC, low HDL-c, high TC:HDL-c ratio, high LDL-c, and high TG were found in 52.4, 36.5, 18.8, 44.1, and 42.9%, respectively. Seventy-five subjects (44.1%) were taking lipid-lowering drugs. Only 54 subjects (31.8%) had baseline serum lipid profiles tested before beginning PI. There was statistically significant association between group of PI with serum TC and TG. Subjects taking double boosted and single boosted PI had significantly higher serum TC and TG levels than unboosted PI. Males had significantly higher serum TG levels, while females had significantly higher serum HDL-c levels. Age was significantly associated with serum TC, LDL-c levels, and TC:HDL-c ratios. Serum TC and LDL-c levels were also significantly higher in subjects taking efavirenz.
血脂异常是接受基于蛋白酶抑制剂（PI）的抗逆转录病毒疗法（ART）的HIV感染患者中常见的代谢并发症。为了评估脂质异常的患病率及相关因素，于2005年1月至8月在泰国曼谷朱拉隆功国王纪念医院的HIV门诊，对170名接受含PI的高效抗逆转录病毒治疗（HAART）的泰国成年HIV感染患者的血脂谱进行了一项横断面分析研究。研究对象的中位年龄为40岁，服用PI的中位时间为22.1个月。血清总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）和甘油三酯（TG）的平均水平分别为259.7、43.7、135.2和506.8mg/dl，平均TC:HDL-c比值为6.4。根据美国国家胆固醇教育计划（NCEP）成人治疗小组第三次报告（ATP III）指南，高TC、低HDL-c、高TC:HDL-c比值、高LDL-c和高TG分别占52.4%、36.5%、18.8%、44.1%和42.9%。75名受试者（44.1%）正在服用降脂药物。只有54名受试者（31.8%）在开始服用PI之前检测了基线血脂谱。PI组与血清TC和TG之间存在统计学显著关联。服用双倍增强和单倍增强PI的受试者血清TC和TG水平显著高于未增强PI的受试者。男性的血清TG水平显著更高，而女性的血清HDL-c水平显著更高。年龄与血清TC、LDL-c水平以及TC:HDL-c比值显著相关。服用依非韦伦的受试者血清TC和LDL-c水平也显著更高。
