Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Maturitas. 2024 Sep;187:108069. doi: 10.1016/j.maturitas.2024.108069. Epub 2024 Jul 17.
Menopause and HIV are associated with cardiometabolic disease. In sub-Saharan Africa there is a growing population of midlife women living with HIV and a high prevalence of cardiometabolic disease.
The aim of this study was to determine whether menopause and HIV were associated with cardiometabolic disease risk factors in a population of midlife sub-Saharan African women.
This was a cross-sectional comparison of cardiometabolic disease risk factors between 944 premenopausal women (733 living without HIV and 211 living with HIV) and 1135 postmenopausal women (932 living without HIV and 203 living with HIV) in sub-Saharan Africa.
Anthropometric and cardiometabolic variables were compared between pre- and postmenopausal women living without HIV and between pre- and postmenopausal women living with HIV and between women living without HIV and women living with HIV.
The prevalence of HIV was 19.9 %. Age at menopause was lower in women living with HIV than in women living without HIV (48.1 ± 5.1 vs 50.9 ± 4.7 years, p < 0.001). Women living with HIV and receiving efavirenz-based antiretroviral therapy had a lower body mass index (BMI), hip circumference, blood pressure and carotid intima media thickness but higher triglyceride levels and insulin resistance than women living without HIV. Antiretroviral therapy-naïve women living with HIV had lower HDL-cholesterol than women living without HIV. In this study, menopause was associated with higher LDL-C levels, regardless of HIV status.
The high prevalence of obesity and related cardiometabolic disease risk factors in these midlife sub-Saharan African women is not related to the menopausal transition. The association of cardiometabolic disease risk factors with HIV and antiretroviral therapy is complex and requires further investigation in longitudinal studies, as does the negative association of age at final menstrual period with HIV.
绝经和 HIV 与心血管代谢疾病有关。在撒哈拉以南非洲，有越来越多的中年女性携带 HIV 生活，且心血管代谢疾病的患病率很高。
本研究旨在确定绝经和 HIV 是否与撒哈拉以南非洲中年女性的心血管代谢疾病危险因素有关。
这是一项横断面比较，比较了 944 名绝经前女性（733 名未感染 HIV，211 名感染 HIV）和 1135 名绝经后女性（932 名未感染 HIV，203 名感染 HIV）的心血管代谢疾病危险因素。
比较未感染 HIV 的绝经前和绝经后女性以及感染 HIV 的绝经前和绝经后女性之间以及未感染 HIV 的女性与感染 HIV 的女性之间的人体测量学和心血管代谢变量。
HIV 的患病率为 19.9%。感染 HIV 的女性绝经年龄低于未感染 HIV 的女性（48.1±5.1 岁比 50.9±4.7 岁，p<0.001）。接受依非韦伦为基础的抗逆转录病毒治疗的感染 HIV 的女性体重指数（BMI）、臀围、血压和颈动脉内膜中层厚度较低，但甘油三酯水平和胰岛素抵抗较高，而未感染 HIV 的女性 HDL-胆固醇水平较低。未接受抗逆转录病毒治疗的感染 HIV 的女性与未感染 HIV 的女性相比，HDL-胆固醇水平较低。在本研究中，无论 HIV 状态如何，绝经与 LDL-C 水平升高有关。
这些撒哈拉以南非洲中年女性肥胖和相关心血管代谢疾病危险因素的高患病率与绝经过渡无关。心血管代谢疾病危险因素与 HIV 和抗逆转录病毒治疗的关联是复杂的，需要进一步在纵向研究中进行调查，绝经年龄与 HIV 的负相关也需要进一步调查。
