Department of Infectology and Tropical Medicine, Faculty of Medicine - Federal University of Minas Gerais (UFMG) - Belo Horizonte, Minas Gerais - Brazil
Department of Infectology and Tropical Medicine, Faculty of Medicine - Federal University of Minas Gerais (UFMG) - Belo Horizonte, Minas Gerais - Brazil.
Clin Med Res. 2020 Dec;18(4):120-125. doi: 10.3121/cmr.2020.1509. Epub 2020 Apr 27.
Dyslipidemia and central obesity are the main components of metabolic syndrome, which represent important risk factors for cardiovascular diseases in people living with human immunodeficiency virus (HIV). The lipid accumulation product (LAP) index has been shown in studies as an efficient marker of metabolic syndrome in general adult population and its applicability in HIV-infected population is not discussed. We aimed to assess the accuracy of the LAP index to identify metabolic syndrome in people living with HIV.
It is a cross-sectional study with 141 HIV-infected patients on antiretroviral therapy, conducted in a reference centre of infectious diseases in southeast Brazil. Evaluations included LAP index, anthropometric measurements and clinical and laboratorial variables. Metabolic syndrome was defined by International Diabetes Federation (IDF) criteria.
The prevalence of metabolic syndrome in our sample was 10.6%. A positive and significant correlation was found between the metabolic syndrome and LAP (r=0.401; <0.01), metabolic syndrome and body mass index (r=0.361; <0.01) and metabolic syndrome and waist circumference (r=0.427; <0.01) in our sample. The analysis of the receiver-operating characteristic (ROC) curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 59.4 (sensitivity 80%, specificity 79% and area under the curve (AUC) of 0.875. In female and male, analysis of the ROC curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 56.3 (sensitivity 100%, specificity 82% and AUC of 0.929) and 52.0 (sensitivity 78%, specificity 74% and AUC of 0.838), respectively.
Despite the low prevalence of metabolic syndrome in our sample, the ROC curves analyzes demonstrated a good diagnostic accuracy as an additional screening tool of metabolic syndrome according to the IDF.
血脂异常和中心性肥胖是代谢综合征的主要组成部分，它们是人类免疫缺陷病毒（HIV）感染者发生心血管疾病的重要危险因素。脂质蓄积产物（LAP）指数在一般成年人群中被证明是代谢综合征的有效标志物，但在 HIV 感染者中的适用性尚未讨论。我们旨在评估 LAP 指数在识别 HIV 感染者代谢综合征方面的准确性。
这是一项在巴西东南部传染病参考中心进行的 141 名接受抗逆转录病毒治疗的 HIV 感染患者的横断面研究。评估包括 LAP 指数、人体测量学测量以及临床和实验室变量。代谢综合征按照国际糖尿病联合会（IDF）标准定义。
我们样本中的代谢综合征患病率为 10.6%。在我们的样本中，代谢综合征与 LAP（r=0.401；<0.01）、代谢综合征与体重指数（r=0.361；<0.01）和代谢综合征与腰围（r=0.427；<0.01）之间存在正相关且有统计学意义。受试者工作特征（ROC）曲线分析显示，LAP 指数定义代谢综合征的最佳截断值为 59.4（灵敏度 80%，特异性 79%，曲线下面积（AUC）为 0.875。在女性和男性中，ROC 曲线分析显示，LAP 指数定义代谢综合征的最佳截断值分别为 56.3（灵敏度 100%，特异性 82%，AUC 为 0.929）和 52.0（灵敏度 78%，特异性 74%，AUC 为 0.838）。
尽管我们样本中的代谢综合征患病率较低，但 ROC 曲线分析表明，LAP 指数作为 IDF 标准的代谢综合征的附加筛查工具具有良好的诊断准确性。
