Metabolic syndrome and cardiovascular risk in HIV-infected patients with lipodystrophy.
In this cross-sectional study, we evaluate potential predictors of Metabolic Syndrome (MS) in a group of 54 Caucasian chronically HIV-infected patients with lipodystrophy. According to ATP-III criteria, 22 patients were affected by MS and 32 were not. The mean age of the sample was 41.2+/-8.6 years, and most patients were males (74.1%); the two groups were homogeneous for gender, age, viro-immunologic status and the duration of antiviral therapy. The independent association between MS and several factors including demographic characteristics, type of highly-active antiviral therapy (HAART), viro-immunologic response, common cardiovascular risk factors (including Framingham scores), and selected cytokines (IFN-gamma, TNF-alpha, IL-2, IL-4, IL-6, IL-10 and IL-18), was investigated using stepwise forward logistic regression. At multivariate analysis, the only independent predictors of the metabolic syndrome were triglycerides and IL-18. A 10 mg/dL increase in triglycerides corresponds to an adjusted risk ratio for MS of 1.11 (95 percent IC: 1.04-1.19); and patients in the top tertile of IL-18 (those with IL-18 >/= 530 pg/L) had more than three times the likelihood of MS, as compared to the bottom and medium tertiles of IL-18 (patients with IL-18< 530 pg/L). This relationship was not attenuated by the inclusion of any other variable in the multivariate model. However, the association between metabolic syndrome and IL-18 is no longer significant when IL-18 is treated as a continuous variable (trend p = 0.087). Our results on HIV patients with lipodystrophy confirm previous findings on a strong independent association between IL-18 and MS in the general population. Further research is needed to clarify the mechanism of this association and its role in the development of cardiovascular disease in HIV patients.
Falasca
K
K
Department of Medicine and Aging, University G.d'Annunzio, Chieti, Italy.
Ucciferri
C
C
Manzoli
L
L
Mancino
P
P
Pizzigallo
E
E
Conti
P
P
Vecchiet
J
J
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology*; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism; D039682:HIV-Associated Lipodystrophy Syndrome / Q000209:etiology / Q000276:immunology / Q000378:metabolism; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology* / Q000276:immunology / Q000378:metabolism; D011379:Prognosis; D012306:Risk; D014280:Triglycerides / Q000097:blood; D019562:Viral Load
D019380:Anti-HIV Agents; D016207:Cytokines; D014280:Triglycerides