Department of Endocrinology, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, Spain.
Metab Syndr Relat Disord. 2011 Oct;9(5):345-51. doi: 10.1089/met.2010.0129. Epub 2011 May 4.
The aim of this study was to compare the prevalence of metabolic syndrome in human immunodeficiency virus (HIV)-infected patients treated with highly active antiretroviral therapy (HAART), using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), European Group for the Study of Insulin Resistance (EGIR), and International Diabetes Federation (IDF) definitions.
A cross-sectional study was carried out with 159 consecutive adult HIV-infected subjects (120 males and 39 females) under HAART. Anthropometric and laboratory parameters were measured by standard methods. Hyperinsulinemia was defined by a fasting concentration >75th percentile of values obtained in healthy individuals (107.5 pmol/L).
The prevalence of ATP III-defined metabolic syndrome was 10.1%; it was 28.3% according to EGIR criteria and 15.1% using the IDF definition. The concordance between the definitions was low (kappa coefficient ranging between 0.134 and 0.296). All subjects with EGIR-defined metabolic syndrome had hyperinsulinemia, but only 50% of those with ATP III-defined metabolic syndrome and 62.5% in the IDF metabolic syndrome population had hyperinsulinemia.
The inclusion of hyperinsulinemia as a criterion in the EGIR metabolic syndrome definition made it more discriminative than the ATP III definition, both in men and women, and than the IDF definition in men to identify metabolic syndrome in HIV-infected subjects under HAART.
本研究旨在比较使用国家胆固醇教育计划成人治疗专家组第三版（NCEP ATP III）、欧洲胰岛素抵抗研究组（EGIR）和国际糖尿病联合会（IDF）定义，在接受高效抗逆转录病毒治疗（HAART）的人类免疫缺陷病毒（HIV）感染患者中代谢综合征的患病率。
对 159 例连续接受 HAART 的成年 HIV 感染患者（120 名男性和 39 名女性）进行了一项横断面研究。采用标准方法测量人体测量和实验室参数。空腹胰岛素浓度>健康个体获得的第 75 百分位数（107.5 pmol/L）定义为高胰岛素血症。
根据 ATP III 定义，代谢综合征的患病率为 10.1%；根据 EGIR 标准为 28.3%，根据 IDF 定义为 15.1%。这些定义之间的一致性较低（kappa 系数在 0.134 至 0.296 之间）。所有符合 EGIR 定义的代谢综合征患者均有高胰岛素血症，但只有 50%的 ATP III 定义的代谢综合征患者和 62.5%的 IDF 代谢综合征患者有高胰岛素血症。
将高胰岛素血症纳入 EGIR 代谢综合征定义的标准使其在男性和女性中比 ATP III 定义更具鉴别力，在男性中比 IDF 定义更能识别接受 HAART 的 HIV 感染患者中的代谢综合征。
