Prevalence and predictors of metabolic syndrome among HIV-infected and HIV-uninfected women in the Women's Interagency HIV Study.
OBJECTIVE
To assess the prevalence of metabolic syndrome (MetSynd) among participants of the Women's Interagency HIV Study and to describe the association of MetSynd with HIV infection, antiretroviral therapies, and sociodemographic factors.


METHODS
Prevalence of MetSynd, defined by updated Adult Treatment Panel III guidelines, was assessed among 2393 (1725 seropositive and 668 seronegative) participants from the Women's Interagency HIV Study seen between October 2000 and October 2004.


RESULTS
HIV-1 infection was independently associated with MetSynd [33% vs 22%, P<0.0001 in HIV-seropositive compared with HIV-seronegative women; adjusted odds ratio (OR) 1.79 (95% confidence interval 1.48, 2.16)]. HIV-infected women had higher mean triglyceride (154 vs 101 mg/dL, P<0.0001) and lower mean high-density lipoprotein cholesterol levels (46 vs 55 mg/dL, P<0.0001). Most notable factors associated with higher prevalence of MetSynd among HIV-infected women included older age (OR=1.38 per 5 year increase, P<0.0001); higher body mass index; current smoking; HIV-1 RNA (OR=1.36, P=0.019, for >50,000 vs <80 copies/mL); and use of stavudine (OR=1.28, P=0.009). Nevirapine use was protective (OR=0.75, P=0.016). There was no significant association of MetSynd with ritonavir-boosted protease inhibitors (OR=1.15, P=0.134).


CONCLUSIONS
MetSynd is more prevalent in HIV-seropositive than HIV-seronegative women. This increased prevalence was due to dyslipidemias rather than higher blood pressure, glucose, or waist circumference.
Division of Infectious Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. mes52@columbia.edu
Magdalena E
ME
Sobieszczyk
Donald R
DR
Hoover
Kathryn
K
Anastos
Kathleen
K
Mulligan
Tianren
T
Tan
Qiuhu
Q
Shi
Wei
W
Gao
Charles
C
Hyman
Mardge H
MH
Cohen
Stephen R
SR
Cole
Michael W
MW
Plankey
Alexandra M
AM
Levine
Jessica
J
Justman
D000328:Adult; D044966:Anti-Retroviral Agents; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000150:complications*; D018023:HIV Seronegativity; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors
D044966:Anti-Retroviral Agents