Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
ASEAN Institute for Health Development, Mahidol University, 999 Phuttamontol Sai 4, Salaya, Phuttamontol, Nakhon Pathom, 73170, Thailand.
BMC Public Health. 2024 Sep 28;24(1):2657. doi: 10.1186/s12889-024-20118-3.
Metabolic syndrome (MetS) elevates the risk of heart disease and stroke. In recent decades, the escalating prevalence of MetS among people living with HIV/AIDS (PLWHA) has garnered global attention. Despite MetS development being associated with both traditional and HIV-related factors, evidence from prior studies has shown variability across geographical regions. This study aimed to conduct a systematic review and meta-analysis of MetS burdens in adult PLWHA at the regional and global levels, focusing on the common effect size of HIV infection and antiretroviral therapy (ART) on MetS.
This review followed the PRISMA 2020 guidelines. A comprehensive search and review of original articles related to MetS and HIV published in peer-reviewed journals between January 2000 and December 2023 were conducted. A random effects model was used to calculate the pooled prevalence/incidence of MetS and the common effect size of HIV infection and ART exposure on MetS.
A total of 102 studies from five continents comprising 78,700 HIV-infected participants were included. The overall pooled prevalence of MetS was 25.3%, 25.6% for PLWHA on ART, and 18.5% for those not receiving treatment. The pooled incidence of MetS, calculated from five studies, was 9.19 per 100 person-years. The highest pooled prevalence of MetS was observed in the Americas (30.4%), followed by the Southeast Asia/Western Pacific regions (26.7%). HIV-infected individuals had 1.6 times greater odds of having MetS than non-HIV-infected individuals did (pooled OR = 1.604; 95% CI 1.154-2.230), and ART exposure had 1.5 times greater odds of having MetS than nontreatment had (pooled OR = 1.504; 95% CI 1.217-1.859).
HIV infection and ART exposure contribute significantly to the increased burden of MetS. Regions with a high burden of HIV and MetS should prioritize awareness and integrated care plans for major noncommunicable diseases (NCDs), such as heart disease and stroke. The implementation of integrated care for HIV/AIDS patients and NCDs is essential for addressing the high burden of multimorbidity in PLWHA.
INPLASY202290018.
代谢综合征（MetS）会增加患心脏病和中风的风险。近几十年来，艾滋病毒/艾滋病感染者（PLWHA）中代谢综合征的患病率不断上升，引起了全球关注。尽管代谢综合征的发生与传统因素和 HIV 相关因素都有关，但先前研究的证据表明，不同地理区域的情况存在差异。本研究旨在对成人 PLWHA 中代谢综合征的负担进行系统的综述和荟萃分析，重点关注 HIV 感染和抗逆转录病毒治疗（ART）对代谢综合征的常见影响大小。
本综述遵循 PRISMA 2020 指南。对 2000 年 1 月至 2023 年 12 月期间在同行评议期刊上发表的与代谢综合征和 HIV 相关的原始文章进行了全面的搜索和综述。使用随机效应模型计算代谢综合征的总患病率/发病率，以及 HIV 感染和 ART 暴露对代谢综合征的常见影响大小。
共纳入来自五大洲的 102 项研究，包含 78700 名 HIV 感染者。代谢综合征的总患病率为 25.3%，接受 ART 的 PLWHA 为 25.6%，未接受治疗的患者为 18.5%。从五项研究中计算得出，代谢综合征的累积发病率为每 100 人年 9.19 例。代谢综合征的最高总患病率出现在美洲（30.4%），其次是东南亚/西太平洋地区（26.7%）。与未感染 HIV 的个体相比，感染 HIV 的个体患代谢综合征的可能性高 1.6 倍（汇总 OR=1.604；95%CI 1.154-2.230），接受 ART 治疗的个体患代谢综合征的可能性高 1.5 倍（汇总 OR=1.504；95%CI 1.217-1.859）。
HIV 感染和 ART 暴露显著增加了代谢综合征的负担。HIV 和代谢综合征负担较高的地区应优先重视对主要非传染性疾病（NCD）的认识和综合护理计划，如心脏病和中风。实施对 HIV/AIDS 患者和 NCD 的综合护理对于解决 PLWHA 中多种疾病的高负担至关重要。
INPLASY202290018。
