全球成年 HIV 感染人群中代谢综合征的负担：系统评价和荟萃分析。

Burden of metabolic syndrome in the global adult HIV-infected population: a systematic review and meta-analysis.

机构信息

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.

出版信息

BMC Public Health. 2024 Sep 28;24(1):2657. doi: 10.1186/s12889-024-20118-3.

DOI:10.1186/s12889-024-20118-3

PMID:39342258

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11438355/

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

REGISTRATION NUMBER

INPLASY202290018.

摘要

背景

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。

方法

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。

结果

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）。