Metabolic syndrome and subclinical atherosclerosis in patients infected with HIV.
BACKGROUND
The present study examines the association between carotid and coronary atherosclerosis and metabolic syndrome in human immunodeficiency virus (HIV)-infected adults.


METHODS
We measured the common and internal carotid intima-media thickness (c-IMT) using B-mode ultrasonography, and we measured coronary artery calcium (CAC) using high-resolution, electrocardiographic, synchronized, computed tomography, for 314 HIV-infected men and women. Metabolic syndrome was defined by National Cholesterol Education Program/Adult Treatment Panel III criteria. We compared the c-IMT measurements and CAC scores of patients with metabolic syndrome with the scores of those without metabolic syndrome using a Wilcoxon test for continuous variables and a chi2 test for categorical variables. To examine the association between surrogate markers and metabolic syndrome, we used logistic regression analysis.


RESULTS
Participants with metabolic syndrome were more likely to have a common c-IMT measurement >0.8 mm than were those without metabolic syndrome (17% vs.7%; P=.009), but both groups were equally likely to have an internal c-IMT measurement >1.0 mm (20% vs. 13%; P=.15). Any positive CAC score was more likely to occur for participants with metabolic syndrome (80.3% vs. 46.7%; P<.0001). In a multivariate model adjusted for sex, age, ethnicity, and smoking status, participants with metabolic syndrome were more likely than those without metabolic syndrome to have an abnormal common c-IMT measurement (odds ratio [OR], 2.9; P=.020) and detectable CAC scores (OR, 4.9; P<.0001) but not a higher internal c-IMT measurement (OR, 1.6; P=.255).


CONCLUSIONS
Our study demonstrates that HIV-infected individuals with metabolic syndrome may be at increased risk for subclinical atherosclerosis and supports screening for metabolic syndrome among HIV-infected patients at risk for cardiovascular disease.
Mangili
Alexandra
A
Department of Medicine, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA. amangili@tufts-NEMC.org
Jacobson
Denise L
DL
Gerrior
Jul
J
Polak
Joseph F
JF
Gorbach
Sherwood L
SL
Wanke
Christine A
CA
D000328:Adult; D002340:Carotid Artery Diseases / Q000378:metabolism / Q000821:virology*; D003324:Coronary Artery Disease / Q000378:metabolism / Q000821:virology*; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism / Q000473:pathology / Q000821:virology*; D008875:Middle Aged