Metabolic syndrome: a major risk factor for atherosclerosis in HIV-infected patients (SHIVA study).
OBJECTIVE
Metabolic syndrome (MetS) is directly related to a high incidence of cardiovascular disease in the general population. The association is more doubtful among HIV-infected patients, although MetS has an elevated prevalence in this population. We explored the impact of MetS on early atherosclerosis markers.


METHODS
All HIV-infected outpatients followed at the Brest University Hospital were included in this cross-sectional hospital-based study (SHIVA study, France) (n=154). The MetS status (NCEP ATPIII definition, at least three of these five criteria: fasting glucose, triglycerides, HDL-C, waist circumference and hypertension.) of each patient was analyzed (Mann-Whitney test) according to carotid intima-media thickness, number of plaques, and a combined cardiovascular score.


RESULTS
After exclusion of 6 patients treated with statins or insulin or both, MetS status was available for 140 (90.9%) patients and positive for 10 (7.1%). MetS status was due predominantly to blood glucose and triglyceride levels and was strongly correlated with all atherosclerosis markers (p < or = 0.01).


CONCLUSIONS
The MetS prevalence in this population is low for a group with HIV infection, even after inclusion of the statin-treated patients (11.4%), but remains higher than among the general population. MetS in this population is probably a heterogeneous cluster of side effects of antiretroviral therapy (high triglycerides, lower HDL-C, and hypertension) and direct effects of HIV (glucose disturbances). Because it is strongly linked to the presence of plaque and intimal thickness, it is a pertinent criterion for deciding about cardiovascular prevention.
Martin
Luc de Saint
Lde S
Internal medicine department (EA 3878), University Hospital, F-29609 Brest Cedex, France.
Pasquier
Elisabeth
E
Roudaut
Nathalie
N
Vandhuick
Olivier
O
Vallet
Sophie
S
Bellein
Véronique
V
Bressollette
Luc
L
D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology*; D001786:Blood Glucose / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000473:pathology
D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides