Nguyen Kim Anh, Peer Nasheeta, de Villiers Anniza, Mukasa Barbara, Matsha Tandi E, Mills Edward J, Kengne Andre Pascal
Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; Department of Medicine, University of Cape Town, Cape Town 7935, South Africa.
Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa.
Int J Endocrinol. 2017;2017:1613657. doi: 10.1155/2017/1613657. Epub 2017 Mar 14.
We determined metabolic syndrome (MetS) prevalence and assessed the agreement between different diagnostic criteria in HIV-infected South Africans. . A random sample included 748 HIV-infected adult patients (79% women) across 17 HIV healthcare facilities in the Western Cape Province. MetS was defined using the Joint Interim Statement (JIS 2009), International Diabetes Federation (IDF 2005), and Adult Treatment Panel III (ATPIII 2005) criteria. . Median values were 38 years (age), 5 years (diagnosed HIV duration), and 392 cells/mm (CD4 count), and 93% of the participants were on antiretroviral therapy (ART). MetS prevalence was 28.2% (95%CI: 25-31.4), 26.5% (23.3-29.6), and 24.1% (21-27.1) by the JIS, IDF, and ATPIII 2005 criteria, respectively. Prevalence was always higher in women than in men (all < 0.001), in participants with longer duration of diagnosed HIV (all ≤ 0.003), and in ART users not receiving 1st-line regimens (all ≤ 0.039). The agreement among the three criteria was very good overall and in most subgroups (all kappa ≥ 0.81). . The three most popular diagnostic criteria yielded similarly high MetS prevalence in this relatively young population receiving care for HIV infection. Very good levels of agreement between criteria are unaffected by some HIV-specific features highlighting the likely comparable diagnostic utility of those criteria in routine HIV care settings.
我们确定了代谢综合征（MetS）的患病率，并评估了南非HIV感染者中不同诊断标准之间的一致性。在西开普省的17家HIV医疗机构中，随机抽取了748名成年HIV感染患者（79%为女性）。采用联合临时声明（JIS 2009）、国际糖尿病联盟（IDF 2005）和成人治疗小组III（ATPIII 2005）标准来定义MetS。中位年龄为38岁，确诊HIV病程为5年，CD4细胞计数为392个/mm³，93%的参与者正在接受抗逆转录病毒治疗（ART）。根据JIS、IDF和ATPIII 2005标准，MetS患病率分别为28.2%（95%CI：25 - 31.4）、26.5%（23.3 - 29.6）和24.1%（21 - 27.1）。女性患病率始终高于男性（所有P < 0.001），确诊HIV病程较长的参与者中患病率更高（所有P ≤ 0.003），以及未接受一线治疗方案的ART使用者中患病率更高（所有P ≤ 0.039）。总体而言，这三种标准之间的一致性非常好，在大多数亚组中也是如此（所有kappa≥0.81）。在这个接受HIV感染治疗的相对年轻人群中，这三种最常用的诊断标准得出的MetS患病率同样很高。标准之间非常好的一致性不受某些HIV特异性特征的影响，这突出了这些标准在常规HIV护理环境中可能具有的可比诊断效用。
