Incidence of metabolic syndrome in a cohort of HIV-infected adults and prevalence relative to the US population (National Health and Nutrition Examination Survey).
BACKGROUND
Metabolic syndrome increases the risk of cardiovascular outcomes and type II diabetes. Most of the metabolic abnormalities defining metabolic syndrome are observed in HIV.


OBJECTIVE
To determine the incidence and risk factors for metabolic syndrome in HIV-infected adults in the Nutrition for Healthy Living (NFHL) study (2000-2003) and prevalence relative to the findings of the National Health and Nutrition Examination Survey (NHANES) (1999-2002).


METHODS
Metabolic syndrome is > or =3 of the following: hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, hypertension, abdominal obesity, and high serum glucose. The baseline prevalence of metabolic syndrome in the NFHL study (n = 477) was compared to that in the NHANES (n = 1876), adjusted for age, race, gender, poverty, exercise, and diet.


RESULTS
Almost one quarter of NFHL subjects had metabolic syndrome. Most with metabolic syndrome (77%) had low HDL and hypertriglyceridemia plus > or =1 additional abnormality. The prevalence of metabolic syndrome was significantly lower in HAART and non-HAART users compared with NHANES participants unadjusted for body mass index (BMI). After adjustment for BMI, it was no longer significant but the trend remained. The incidence of metabolic syndrome in the NFHL study was higher with increasing viral load, higher BMI, higher trunk-to-limb fat ratio, and Kaletra (lopinavir/ritonavir) or didanosine (ddI) use and lower among college-educated persons.


CONCLUSIONS
Metabolic syndrome is mostly diagnosed through low HDL and high triglycerides in HIV. The risk of developing the syndrome is related to HIV, specific medications, and body fat.
Jacobson
Denise L
DL
Department of Public Health and Family Medicine, Tufts University School of Medicine, 136 Harrison Avenue-Posner 4, Boston, MA 02111, USA. denise.jacobson@tufts.edu
Tang
Alice M
AM
Spiegelman
Donna
D
Thomas
Ann M
AM
Skinner
Sally
S
Gorbach
Sherwood L
SL
Wanke
Christine
C
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D015497:HIV-1; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D019380:Anti-HIV Agents