Metabolic abnormalities and coronary heart disease risk in human immunodeficiency virus-infected adults.
BACKGROUND
Metabolic syndrome is a combination of risk factors for cardiovascular disease and diabetes, It has been reported to be increased in human immunodeficiency virus (HIV)-infected individuals.


METHODS
In a cohort of HIV-infected adults we examined parameters that contribute to defining the metabolic syndrome and to estimating the 10-year risk of coronary heart disease (CHD). The study group consisted of 296 participants (217 men and 79 women) of mixed ethnicity with a mean age of 45.3 years.


RESULTS
There was an appreciable prevalence of metabolic syndrome (30.0%), with the frequency increasing to 42.5% in those over 50 years of age. Those with the metabolic syndrome had a lower viral load. More women had abdominal obesity (59.5%) than men (20.7%, P < 0.001). The frequency of elevated plasma glucose was higher in females (37.2%) compared to males (16.9%, P = 0.004). High frequencies of decreased high-density lipoprotein cholesterol (HDL-C) and elevated blood pressure were seen in both sexes. Hypertriglyceridemia was less prevalent in African Americans. In those under 50 years of age, the 10-year CHD risk score for men was double that for women (6.2% vs 2.7%, P < 0.001). In older participants, the risk was similar between the sexes, with a third having scores over 10%.


CONCLUSIONS
The prevalence of metabolic syndrome was higher than in most other HIV cohorts. Those with the syndrome had significantly lower viral loads. Mean 10-year Framingham Cardiovascular Risk (FCR) scores were nearly doubled for those with metabolic syndrome. Both researchers and clinicians should consider age as well as sex when assessing patients with HIV infection for risks associated with metabolic syndrome.
Cardiovascular Research Institute, University of California, San Francisco, CA 94143-0130, USA. clive.pullinger@ucsf.edu
Clive R
CR
Pullinger
Bradley E
BE
Aouizerat
Caryl
C
Gay
Traci
T
Coggins
Irina
I
Movsesyan
Harvey
H
Davis
John P
JP
Kane
Carmen
C
Portillo
Kathryn A
KA
Lee
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000453:epidemiology / Q000821:virology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism / Q000821:virology*; D006801:Humans; D006943:Hyperglycemia / Q000821:virology; D006973:Hypertension / Q000821:virology; D015228:Hypertriglyceridemia / Q000821:virology; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000821:virology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D013997:Time Factors; D019562:Viral Load; D055815:Young Adult
D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids