Sobieszczyk Magdalena E, Hoover Donald R, Anastos Kathryn, Mulligan Kathleen, Tan Tianren, Shi Qiuhu, Gao Wei, Hyman Charles, Cohen Mardge H, Cole Stephen R, Plankey Michael W, Levine Alexandra M, Justman Jessica
Division of Infectious Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
J Acquir Immune Defic Syndr. 2008 Jul 1;48(3):272-80. doi: 10.1097/QAI.0b013e31817af461.
To assess the prevalence of metabolic syndrome (MetSynd) among participants of the Women's Interagency HIV Study and to describe the association of MetSynd with HIV infection, antiretroviral therapies, and sociodemographic factors.
Prevalence of MetSynd, defined by updated Adult Treatment Panel III guidelines, was assessed among 2393 (1725 seropositive and 668 seronegative) participants from the Women's Interagency HIV Study seen between October 2000 and October 2004.
HIV-1 infection was independently associated with MetSynd [33% vs 22%, P<0.0001 in HIV-seropositive compared with HIV-seronegative women; adjusted odds ratio (OR) 1.79 (95% confidence interval 1.48, 2.16)]. HIV-infected women had higher mean triglyceride (154 vs 101 mg/dL, P<0.0001) and lower mean high-density lipoprotein cholesterol levels (46 vs 55 mg/dL, P<0.0001). Most notable factors associated with higher prevalence of MetSynd among HIV-infected women included older age (OR=1.38 per 5 year increase, P<0.0001); higher body mass index; current smoking; HIV-1 RNA (OR=1.36, P=0.019, for >50,000 vs <80 copies/mL); and use of stavudine (OR=1.28, P=0.009). Nevirapine use was protective (OR=0.75, P=0.016). There was no significant association of MetSynd with ritonavir-boosted protease inhibitors (OR=1.15, P=0.134).
MetSynd is more prevalent in HIV-seropositive than HIV-seronegative women. This increased prevalence was due to dyslipidemias rather than higher blood pressure, glucose, or waist circumference.
评估女性机构间HIV研究参与者中代谢综合征（MetSynd）的患病率，并描述MetSynd与HIV感染、抗逆转录病毒疗法及社会人口学因素之间的关联。
根据更新的成人治疗小组III指南定义的MetSynd患病率，在2000年10月至2004年10月期间接受观察的2393名女性机构间HIV研究参与者（1725名血清阳性和668名血清阴性）中进行评估。
HIV-1感染与MetSynd独立相关[HIV血清阳性女性与HIV血清阴性女性相比，分别为33%对22%，P<0.0001；校正优势比（OR）为1.79（95%置信区间1.48，2.16）]。HIV感染女性的平均甘油三酯水平较高（154对101mg/dL，P<0.0001），平均高密度脂蛋白胆固醇水平较低（46对55mg/dL，P<0.0001）。与HIV感染女性中MetSynd患病率较高相关的最显著因素包括年龄较大（每增加5岁OR=1.38，P<0.0001）；较高的体重指数；当前吸烟；HIV-1 RNA（>50,000拷贝/mL与<80拷贝/mL相比，OR=1.36，P=0.019）；以及使用司他夫定（OR=1.28，P=0.009）。使用奈韦拉平具有保护作用（OR=0.75，P=0.016）。MetSynd与利托那韦增强的蛋白酶抑制剂之间无显著关联（OR=1.15，P=0.134）。
HIV血清阳性女性中MetSynd比HIV血清阴性女性更普遍。这种患病率的增加是由于血脂异常，而非更高的血压、血糖或腰围。
