Copenhagen HIV Programme, University of Copenhagen, Copenhagen, Denmark.
AIDS. 2010 Jan 28;24(3):427-35. doi: 10.1097/QAD.0b013e328334344e.
This study describes the characteristics of the metabolic syndrome in HIV-positive patients in the Data Collection on Adverse Events of Anti-HIV Drugs study and discusses the impact of different methodological approaches on estimates of the prevalence of metabolic syndrome over time.
We described the prevalence of the metabolic syndrome in patients under follow-up at the end of six calendar periods from 2000 to 2007. The definition that was used for the metabolic syndrome was modified to take account of the use of lipid-lowering and antihypertensive medication, measurement variability and missing values, and assessed the impact of these modifications on the estimated prevalence.
For all definitions considered, there was an increasing prevalence of the metabolic syndrome over time, although the prevalence estimates themselves varied widely. Using our primary definition, we found an increase in prevalence from 19.4% in 2000/2001 to 41.6% in 2006/2007. Modification of the definition to incorporate antihypertensive and lipid-lowering medication had relatively little impact on the prevalence estimates, as did modification to allow for missing data. In contrast, modification to allow the metabolic syndrome to be reversible and to allow for measurement variability lowered prevalence estimates substantially.
The prevalence of the metabolic syndrome in cohort studies is largely based on the use of nonstandardized measurements as they are captured in daily clinical care. As a result, bias is easily introduced, particularly when measurements are both highly variable and may be missing. We suggest that the prevalence of the metabolic syndrome in cohort studies should be based on two consecutive measurements of the laboratory components in the syndrome definition.
本研究描述了 Data Collection on Adverse Events of Anti-HIV Drugs 研究中 HIV 阳性患者代谢综合征的特征，并讨论了不同方法学方法对随时间推移代谢综合征患病率估计的影响。
我们描述了从 2000 年至 2007 年的 6 个日历期末接受随访的患者中代谢综合征的患病率。用于代谢综合征的定义经过修改，以考虑降脂和降压药物的使用、测量变异性和缺失值，并评估这些修改对估计患病率的影响。
对于所有考虑的定义，代谢综合征的患病率随时间推移呈上升趋势，尽管患病率估计值本身差异很大。使用我们的主要定义，我们发现患病率从 2000/2001 年的 19.4%增加到 2006/2007 年的 41.6%。将定义修改为纳入降压和降脂药物对患病率估计值的影响相对较小，允许缺失数据的修改也是如此。相比之下，允许代谢综合征可逆和允许测量变异性的修改大大降低了患病率估计值。
队列研究中代谢综合征的患病率在很大程度上基于在日常临床护理中捕获的非标准化测量。因此，很容易引入偏差，尤其是当测量值高度可变且可能缺失时。我们建议，队列研究中代谢综合征的患病率应基于该综合征定义中实验室成分的两次连续测量。
