Rwegerera Godfrey Mutashambara, Shailemo Dorothea H P, Pina Rivera Yordanka, Mokgosi Kathryn O, Bale Portia, Oyewo Taibat Aderonke, Luis Bruno Diaz, Habte Dereje, Godman Brian
Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Department of Medicine, Princess Marina Hospital, Gaborone, Botswana.
Diabetes Metab Syndr Obes. 2021 Jan 11;14:85-97. doi: 10.2147/DMSO.S285720. eCollection 2021.
We primarily aimed at determining the prevalence of metabolic syndrome and abnormal individual metabolic control variables in HIV-infected participants as compared to HIV-uninfected participants given current concerns. Our secondary objective was to determine the predictors of metabolic syndrome and individual metabolic control variables among the study participants to guide future management.
A descriptive, case-matched cross-sectional study for four months from 15th June 2019 to 15th October 2019 at Block 6 Diabetes Reference Clinic in Gaborone, Botswana. We compared the proportions of metabolic syndrome and individual metabolic control variables based on gender and HIV status by means of bivariate analysis (Chi-squared test or Fisher's exact test) to determine factors associated with metabolic control. A p-value of less than 0.05 was considered statistically significant.
Overall, 86% of the study participants were found to have metabolic syndrome by International Diabetes Federation (IDF) criteria with 79.8% among HIV-infected and 89.1% among HIV-negative participants (p-value = 0.018). Older age was significantly associated with metabolic syndrome (p-value = 0.008). Female gender was significantly associated with metabolic syndrome as compared to male gender (P-value < 0.001), and with a statistically significant higher proportion of low HDL-C compared to males (P-value < 0.001). Female participants were significantly more likely to be obese as compared to males (P-value < 0.001). High triglycerides were more common in HIV-infected compared to HIV-negative participants (P-value = 0.004). HIV-negative participants were more likely to be obese as compared to HIV-infected participants (P-value = 0.003).
Metabolic syndrome is an appreciable problem in this tertiary clinic in Botswana for both HIV-infected and HIV-negative participants. Future prospective studies are warranted in our setting and similar sub-Saharan settings to enhance understanding of the role played by HAART in causing the metabolic syndrome, and the implications for future patient management.
鉴于当前的关注焦点，我们的主要目标是确定与未感染艾滋病毒的参与者相比，感染艾滋病毒的参与者中代谢综合征及个体代谢控制变量异常的患病率。我们的次要目标是确定研究参与者中代谢综合征及个体代谢控制变量的预测因素，以指导未来的管理。
2019年6月15日至2019年10月15日在博茨瓦纳哈博罗内第6区糖尿病参考诊所进行了为期四个月的描述性病例匹配横断面研究。我们通过双变量分析（卡方检验或费舍尔精确检验）比较了基于性别和艾滋病毒感染状况的代谢综合征及个体代谢控制变量的比例，以确定与代谢控制相关的因素。p值小于0.05被认为具有统计学意义。
总体而言，根据国际糖尿病联盟（IDF）标准，86%的研究参与者患有代谢综合征，其中感染艾滋病毒的参与者中这一比例为79.8%，未感染艾滋病毒的参与者中为89.1%（p值 = 0.018）。年龄较大与代谢综合征显著相关（p值 = 0.008）。与男性相比，女性与代谢综合征显著相关（p值 < 0.001），且与男性相比，女性低高密度脂蛋白胆固醇（HDL-C）的比例在统计学上显著更高（p值 < 0.001）。与男性相比，女性参与者肥胖的可能性显著更高（p值 < 0.001）。与未感染艾滋病毒的参与者相比，感染艾滋病毒的参与者中高甘油三酯更为常见（p值 = 0.004）。与感染艾滋病毒的参与者相比，未感染艾滋病毒的参与者肥胖的可能性更高（p值 = 0.003）。
在博茨瓦纳的这家三级诊所，代谢综合征对于感染艾滋病毒和未感染艾滋病毒的参与者来说都是一个相当严重的问题。在我们的环境以及撒哈拉以南类似环境中，有必要开展未来的前瞻性研究，以加深对高效抗逆转录病毒治疗（HAART）在导致代谢综合征中所起作用的理解，以及对未来患者管理的影响。
