Phalane Edith, Fourie Carla M T, Schutte Aletta E
Hypertension in Africa Research Team, North-West University, South Africa.
Medical Research Council Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, South Africa.
South Afr J HIV Med. 2018 Sep 20;19(1):813. doi: 10.4102/sajhivmed.v19i1.813. eCollection 2018.
The human immunodeficiency virus (HIV) is often accompanied by renal dysfunction. It is expected that metabolic syndrome (MetS) may exacerbate renal impairment.
We therefore determined the prevalence of MetS and the association thereof with renal function in a South African cohort infected with HIV.
We matched 114 HIV-infected (77.3% on antiretroviral therapy [ART] and 22.7% ART-naïve) and 114 HIV-uninfected individuals according to age, sex and locality. We examined cardiovascular, anthropometric and metabolic measurements and determined the MetS. Renal function was assessed using standardised procedures.
The prevalence of MetS was lower in the HIV-infected individuals as compared to the uninfected individuals (28% vs. 44%, = 0.013). The HIV-infected group presented with a lower body mass index (BMI) and waist circumference (WC) (all < 0.001), as well as blood pressure (BP) ( ≤ 0.0021). The results were confirmed when comparing the HIV-infected group using ART ( = 85) and the HIV-uninfected group. When comparing the HIV-infected individuals with MetS to the HIV-uninfected individuals with MetS, no differences in BP were seen. With regard to renal function, the HIV-infected individuals with MetS ( = 32) had 43% higher urinary albumin-creatinine ratio (uACR) compared to the HIV-uninfected individuals with MetS, after adjusting for age, sex and WC ( = 0.032). None of the other renal function markers differed after adjustments for WC or BMI.
The HIV-infected Africans with MetS had almost twofold higher uACR, despite the low prevalence of MetS, compared to their uninfected counterparts. The combination of HIV and MetS seemed to increase the risk for renal impairment.
人类免疫缺陷病毒（HIV）常伴有肾功能障碍。预计代谢综合征（MetS）可能会加重肾功能损害。
因此，我们确定了南非HIV感染队列中MetS的患病率及其与肾功能的关联。
我们根据年龄、性别和地区，将114名HIV感染者（77.3%接受抗逆转录病毒治疗[ART]，22.7%未接受ART）和114名未感染HIV的个体进行匹配。我们检查了心血管、人体测量和代谢指标，并确定了MetS。使用标准化程序评估肾功能。
与未感染个体相比，HIV感染者中MetS的患病率较低（28%对44%，P = 0.013）。HIV感染组的体重指数（BMI）和腰围（WC）较低（均P < 0.001），血压（BP）也较低（P ≤ 0.0021）。在比较接受ART的HIV感染组（n = 85）和未感染HIV组时，结果得到证实。当比较患有MetS的HIV感染者和患有MetS的未感染HIV个体时，则未观察到BP有差异。关于肾功能，在调整年龄、性别和WC后，患有MetS的HIV感染者（n = 32）的尿白蛋白肌酐比值（uACR）比患有MetS的未感染HIV个体高43%（P = 0.032）。在调整WC或BMI后，其他肾功能指标均无差异。
尽管MetS患病率较低，但与未感染的非洲人相比，患有MetS的HIV感染非洲人的uACR几乎高出两倍。HIV和MetS的联合似乎增加了肾功能损害的风险。
