title: Metabolic syndrome in human immunodeficiency virus-positive subjects: prevalence, phenotype, and related alterations in arterial structure and function.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) infection itself and highly active antiretroviral treatment (HAART) have been proposed to be associated with a higher prevalence of metabolic syndrome, but, to date, prevalence and phenotype of metabolic syndrome among HIV subjects and the related structural and functional vascular alterations are not conclusively defined.
  
  
  METHODS
  We analyzed the data of 108 HIV-infected subjects without known cardiovascular risk factors: 72 were on HAART (group A, age 46.5±7.5 years, clinical blood pressure 125.7/74.9±11.6/7.8 mmHg) and there 36 in a naïve group (group B, age 40.7±7.9 years, blood pressure 126/75.8±9.8/7.7 mmHg). A total of 224 healthy subjects served as controls (group C, age 44.9±6.9 years, blood pressure 123.7/75.7±9.8/7.1 mmHg). Arterial stiffness was measured by aorto-femoral pulse wave velocity (PWV, sfigmocor), and carotid intima media thickness (IMT) was measured by a semiautomatic echotracking system (Esaote-WTS).
  
  
  RESULTS
  Metabolic syndrome was more frequent in HIV-positive subjects than in controls (19.4%, 13.8%, 4.5% for groups A, B, and C; P<0.001), with no significant difference between HAART and naïve. In metabolic syndrome subjects, group A displayed lipid profile alterations more frequently (91%, 50%, 57% for groups A, B, and C; P<0.05), whereas others metabolic syndrome components were equally represented in the three groups. In metabolic syndrome subjects, IMT was similar [556±108, 542±164, and 564±110.4 μm for groups A, B, and C; P=not significant (NS)], whereas PWV was significantly greater in HAART subjects when compared with controls (10.8±1.8, 9.±1.1, 9.3±1 cm/sec for groups A, B, and C; P=0.02 for A vs. C). Moreover, in this group (metabolic syndrome+HAART), PWV was higher than in subjects on HAART but without metabolic syndrome.
  
  
  CONCLUSIONS
  HIV subjects showed a higher prevalence and a different pattern of metabolic syndrome components. HAART, more than HIV infection per se, appeared to be responsible for the increased prevalence of metabolic syndrome and arterial function derangement.
authors.affiliation: 1 Internal Medicine Department, San Gerardo Hospital , Monza, Italy .
authors.forename: Alessandro
authors.initials: A
authors.lastname: Maloberti
authors.forename: Christina
authors.initials: C
authors.lastname: Giannattasio
authors.forename: Dario
authors.initials: D
authors.lastname: Dozio
authors.forename: Mauro
authors.initials: M
authors.lastname: Betelli
authors.forename: Paulo
authors.initials: P
authors.lastname: Villa
authors.forename: Stefano
authors.initials: S
authors.lastname: Nava
authors.forename: Francesca
authors.initials: F
authors.lastname: Cesana
authors.forename: Rita
authors.initials: R
authors.lastname: Facchetti
authors.forename: Luca
authors.initials: L
authors.lastname: Giupponi
authors.forename: Francesco
authors.initials: F
authors.lastname: Castagna
authors.forename: Francesca
authors.initials: F
authors.lastname: Sabbatini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bandera
authors.forename: Andre
authors.initials: A
authors.lastname: Gori
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001158:Arteries / Q000473:pathology*; D001794:Blood Pressure; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D012307:Risk Factors; D059289:Vascular Stiffness