艾滋病病毒治疗与甘油三酯升高的可能性高出两倍有关：对撒哈拉以南非洲21023人的汇总分析。
HIV treatment is associated with a two-fold higher probability of raised triglycerides: Pooled Analyses in 21 023 individuals in sub-Saharan Africa.
作者信息
Ekoru Kenneth, Young Elizabeth H, Dillon David G, Gurdasani Deepti, Stehouwer Nathan, Faurholt-Jepsen Daniel, Levitt Naomi S, Crowther Nigel J, Nyirenda Moffat, Njelekela Marina A, Ramaiya Kaushik, Nyan Ousman, Adewole Olanisun O, Anastos Kathryn, Compostella Caterina, Dave Joel A, Fourie Carla M, Friis Henrik, Kruger Iolanthe M, Longenecker Chris T, Maher Dermot P, Mutimura Eugene, Ndhlovu Chiratidzo E, Praygod George, Pefura Yone Eric W, Pujades-Rodriguez Mar, Range Nyagosya, Sani Mahmoud U, Sanusi Muhammad, Schutte Aletta E, Sliwa Karen, Tien Phyllis C, Vorster Este H, Walsh Corinna, Gareta Dickman, Mashili Fredirick, Sobngwi Eugene, Adebamowo Clement, Kamali Anatoli, Seeley Janet, Smeeth Liam, Pillay Deenan, Motala Ayesha A, Kaleebu Pontiano, Sandhu Manjinder S
机构信息
Department of Medicine, University of Cambridge, Cambridge, United Kingdom.
Global Health and Populations Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom.
出版信息
Glob Health Epidemiol Genom. 2018;3. doi: 10.1017/gheg.2018.7. Epub 2018 May 8.
BACKGROUND
Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TG) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.
METHODS
Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.
FINDINGS
Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51-2.77, I=45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.
INTERPRETATION
Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.
背景
在西方人群中，用于治疗艾滋病毒的抗逆转录病毒疗法（ART）与循环甘油三酯（TG）水平升高有关。然而，关于ART对撒哈拉以南非洲（SSA）人群心脏代谢风险影响的数据有限。
方法
对14项研究进行汇总分析，这些研究共纳入21023名个体，于2003年至2014年期间在SSA评估了相关的心脏代谢风险因素（包括TG）、艾滋病毒和ART状态。使用回归模型分析ART与TG升高（>2.3 mmol/L）之间的关联。
结果
在10615名个体中，ART与TG升高的可能性高出两倍相关（风险比2.05，95%置信区间1.51 - 2.77，I² = 45.2%）。在各项研究中，ART与血压升高、血糖、糖化血红蛋白（HbA1c）及其他血脂之间的关联并不一致。
解读
本研究的证据证实了在SSA人群中ART与TG升高之间的关联。鉴于TG升高对心血管疾病（CVD）可能存在因果效应，该证据凸显了开展前瞻性研究以阐明长期ART对SSA地区CVD结局影响的必要性。
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