Nzaramba Daniel, Nkubi Bagenda Charles, Mudondo Hope, Tumusiime Jazira, Ssemwanga Elastus, Muhwezi Darlington, Lumumba Sylvia Achieng, Kiconco Ritah, Rugera Simon Peter
Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara, UGA.
School of Medical Laboratory Technology, Mayanja Memorial Medical Training Institute, Mbarara, UGA.
Cureus. 2025 Jan 8;17(1):e77166. doi: 10.7759/cureus.77166. eCollection 2025 Jan.
This study aimed to investigate the association between the aspartate aminotransferase-to-alanine aminotransferase (AST/ALT) ratio and metabolic syndrome (MetS) among HIV-infected patients on dolutegravir-based antiretroviral therapy (ART).
A cross-sectional study was conducted on 377 adults on dolutegravir-based ART for at least one year. Data were collected from July 1 to August 15, 2024. Participants were systematically sampled, data were collected using a pre-tested questionnaire, anthropometric measurements were taken, and blood samples were collected for biochemical analysis. A low AST/ALT ratio was defined as ≤ 1 and MetS as the presence of at least three of the following: central obesity, fasting hyperglycemia, elevated triglycerides, low HDL-C, and hypertension (International Diabetes Federation (IDF) Consensus worldwide definition, 2006). Logistic regression was used to assess the association between low AST/ALT ratio and MetS, and receiver operating curve (ROC) analysis was conducted to evaluate its predictive performance.
The median age of the participants was 44 years (interquartile range (IQR): 30-59), with 56.2% being female. The prevalence of MetS was 35.3% (133/377, 95%CI: 30.6-40.3). A significant association was found between low AST/ALT ratio and MetS (aOR: 2.19, 95% CI: 1.28-3.73, p = 0.004). Female gender (adjusted odds ratio (aOR): 3.68, 95% CI: 2.07-6.55, p < 0.001) and smoking (aOR: 3.96, 95% CI: 1.77-8.86, p < 0.001) were also significantly associated with MetS. The ALT/AST ratio had a significant predictive power for MetS (AUC = 0.583, 95% CI: 0.523-0.643).
The prevalence of MetS is high. A low AST/ALT ratio is significantly associated with MetS, making it a potential biomarker among HIV patients on ART.
本研究旨在调查接受基于多替拉韦的抗逆转录病毒疗法（ART）的HIV感染患者中，天冬氨酸氨基转移酶与丙氨酸氨基转移酶比值（AST/ALT）与代谢综合征（MetS）之间的关联。
对377名接受基于多替拉韦的ART治疗至少一年的成年人进行了一项横断面研究。数据收集于2024年7月1日至8月15日。参与者采用系统抽样，使用预先测试的问卷收集数据，进行人体测量，并采集血样进行生化分析。低AST/ALT比值定义为≤1，MetS定义为存在以下至少三项：中心性肥胖、空腹血糖升高、甘油三酯升高、高密度脂蛋白胆固醇降低和高血压（国际糖尿病联盟（IDF）2006年全球共识定义）。采用逻辑回归评估低AST/ALT比值与MetS之间的关联，并进行受试者工作特征曲线（ROC）分析以评估其预测性能。
参与者的中位年龄为44岁（四分位间距（IQR）：30 - 59），女性占56.2%。MetS的患病率为35.3%（133/377，95%CI：30.6 - 40.3）。发现低AST/ALT比值与MetS之间存在显著关联（调整后比值比（aOR）：2.19，95%CI：1.28 - 3.73，p = 0.004）。女性（调整后比值比（aOR）：3.68，95%CI：2.07 - 6.55，p < 0.001）和吸烟（aOR：3.96，95%CI：1.77 - 8.86，p < 0.001）也与MetS显著相关。ALT/AST比值对MetS具有显著的预测能力（曲线下面积（AUC） = 0.583，95%CI：0.523 - 0.643）。
MetS的患病率很高。低AST/ALT比值与MetS显著相关，使其成为接受ART的HIV患者中的一个潜在生物标志物。
