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HIV阳性和HIV阴性成年人中的代谢综合征及10年心血管风险:一项横断面研究。

Metabolic syndrome and 10-year cardiovascular risk among HIV-positive and HIV-negative adults: A cross-sectional study.

作者信息

Masyuko Sarah J, Page Stephanie T, Kinuthia John, Osoti Alfred O, Polyak Stephen J, Otieno Fredrick C, Kibachio Joseph M, Mogaka Jerusha N, Temu Tecla M, Zifodya Jerry S, Otedo Amos, Nakanjako Damalie, Hughes James P, Farquhar Carey

机构信息

Ministry of Health, Nairobi, Kenya.

Department of Global Health.

出版信息

Medicine (Baltimore). 2020 Jul 2;99(27):e20845. doi: 10.1097/MD.0000000000020845.

Abstract

To determine the prevalence and correlates of metabolic syndrome (MetS) and compare 10-year cardiovascular disease (CVD) risk among Kenyan adults with and without HIV infection.We conducted a cross-sectional study among adults ≥30 years of age with and without HIV infection seeking care at Kisumu County Hospital. Participants completed a health questionnaire and vital signs, anthropomorphic measurements, and fasting blood were obtained. MetS was defined using 2009 Consensus Criteria and 10-year Atherosclerotic CVD (ASCVD) risk score was calculated. Chi-square, independent t tests, Wilcoxon ranksum test and multivariable logistic regression were used to determine differences and associations between HIV and MetS, CVD risk factors and ASCVD risk score.A total of 300 people living with HIV (PLWHIV) and 298 HIV-negative participants with median age 44 years enrolled, 50% of whom were female. The prevalence of MetS was 8.9% overall, but lower among PLWHIV than HIV-negative participants (6.3% vs 11.6%, respectively; P = .001). The most prevalent MetS components were elevated blood pressure, decreased high density lipoprotein, and abdominal obesity. Adjusting for covariates, PLWHIV were 66% less likely to have MetS compared to HIV-negative participants (adjusted odds ratio [aOR] 0.34; 95% confidence interval [95%CI] 0.18, 0.65; P = .005). Median ASCVD risk score was also lower among PLWHIV compared to HIV-negative participants (1.7% vs 3.0%, P = .002).MetS was more common among HIV-negative than HIV-positive adults, and HIV-negative adults were at greater risk for CVD compared to PLWHIV. These data support integration of routine CVD screening and management into health programs in resource-limited settings, regardless of HIV status.

摘要

为了确定代谢综合征(MetS)的患病率及其相关因素,并比较肯尼亚有和没有感染艾滋病毒的成年人中10年心血管疾病(CVD)风险。我们在基苏木县医院对年龄≥30岁的有和没有感染艾滋病毒且寻求治疗的成年人进行了一项横断面研究。参与者完成了一份健康问卷并测量了生命体征,获取了人体测量数据和空腹血液样本。采用2009年共识标准定义MetS,并计算10年动脉粥样硬化性心血管疾病(ASCVD)风险评分。使用卡方检验、独立t检验、Wilcoxon秩和检验和多变量逻辑回归来确定艾滋病毒与MetS、CVD危险因素和ASCVD风险评分之间的差异和关联。

共有300名艾滋病毒感染者(PLWHIV)和298名艾滋病毒阴性参与者入组,中位年龄为44岁,其中50%为女性。MetS的总体患病率为8.9%,但PLWHIV中的患病率低于艾滋病毒阴性参与者(分别为6.3%和11.6%;P = 0.001)。最常见的MetS组分是血压升高、高密度脂蛋白降低和腹型肥胖。在调整协变量后,与艾滋病毒阴性参与者相比,PLWHIV患MetS的可能性降低了66%(调整后的优势比[aOR]为0.34;95%置信区间[95%CI]为0.18, 0.65;P = 0.005)。与艾滋病毒阴性参与者相比,PLWHIV的ASCVD风险评分中位数也较低(1.7%对3.0%,P = 0.002)。

MetS在艾滋病毒阴性成年人中比在艾滋病毒阳性成年人中更常见,并且与PLWHIV相比,艾滋病毒阴性成年人患CVD的风险更高。这些数据支持在资源有限的环境中将常规CVD筛查和管理纳入健康计划,无论艾滋病毒感染状况如何。

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