Pao Vivian, Lee Grace A, Grunfeld Carl
Department of Veterans Affairs Medical Center, Metabolism Section (Box 111F), 4150 Clement Street, San Francisco, CA 94121, USA.
Curr Atheroscler Rep. 2008 Feb;10(1):61-70. doi: 10.1007/s11883-008-0010-6.
People with HIV infection have metabolic abnormalities that resemble metabolic syndrome (hypertriglyceridemia, low high-density lipoprotein cholesterol, and insulin resistance), which is known to predict increased risk of cardiovascular disease (CVD). However, there is not one underlying cause for these abnormalities and they are not linked to each other. Rather, individual abnormalities can be affected by the host response to HIV itself, specific HIV drugs, classes of HIV drugs, HIV-associated lipoatrophy, or restoration to health. Furthermore, one component of metabolic syndrome, increased waist circumference, occurs less frequently in HIV infection. Thus, HIV infection supports the concept that metabolic syndrome does not represent a syndrome based on a common underlying pathophysiology. As might be predicted from these findings, the prevalence of CVD is higher in people with HIV infection. It remains to be determined whether CVD rates in HIV infection are higher than might be predicted from traditional risk factors, including smoking.
感染艾滋病毒的人存在类似于代谢综合征的代谢异常（高甘油三酯血症、低高密度脂蛋白胆固醇和胰岛素抵抗），已知这会增加心血管疾病（CVD）的风险。然而，这些异常并非由单一潜在原因导致，且它们之间没有关联。相反，个体异常可能受宿主对艾滋病毒本身的反应、特定的抗艾滋病毒药物、抗艾滋病毒药物类别、艾滋病毒相关脂肪萎缩或恢复健康的影响。此外，代谢综合征的一个组成部分，即腰围增加，在艾滋病毒感染中较少出现。因此，艾滋病毒感染支持了这样一种观点，即代谢综合征并非基于共同潜在病理生理学的综合征。从这些发现可以预测，艾滋病毒感染者中CVD的患病率更高。艾滋病毒感染中的CVD发生率是否高于包括吸烟在内的传统风险因素所预测的水平，仍有待确定。
