title: A cross-sectional assessment of metabolic syndrome in HIV-infected people of low socio-economic status receiving antiretroviral therapy.
abstract: BACKGROUND
  Metabolic syndrome (MetS) is a constellation of symptoms used as a measure to identify patients at increased risk for cardiovascular disease, type 2 diabetes, and all-cause mortality. The results of prolonged life expectancy and cumulative toxic effects of antiretroviral therapy increase the chance that HIV can cause clinical abnormalities, including MetS.
  
  
  METHODS
  We evaluated 89 people living with HIV (PLWH; mean age 48 ± 7 years; mean duration of HIV infection 17 ± 12 years; 47% men; 66% African-American, 22% Hispanic, and 10% non-Hispanic white; and 84% unemployed) enrolled in a community-based exercise training and nutrition education program targeting individuals of low socio-economic status (SES). The prevalence of MetS characteristics and the factors associated with the presence of MetS were analyzed.
  
  
  RESULTS
  One in three (33%; 12 men and 17 women) PLWH met ATPIII criteria for MetS. In our cohort, MetS was driven by high waist circumference and elevated blood pressure. In addition, higher use of protease inhibitors, elevated hemoglobin A1c (HbA1c), greater self-reported daily caloric intake and consumption of carbohydrates, sugar, added sugar, and higher glycemic load were found among the individuals with MetS, compared to those without it. Elevated HbA1c and high total sugar consumption were the strongest predictors and accounted for 30% of the occurrence of MetS.
  
  
  CONCLUSIONS
  The overall prevalence of MetS in our PLWH cohort receiving antiretroviral therapy is higher than previously reported in the general population and in other PLWH cohorts. Additional work is needed to determine whether MetS is a more disease dependent or lifestyle dependent condition in PLWH.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Miami, FL 33136 USA.
authors.forename: Eduard
authors.initials: E
authors.lastname: Tiozzo
authors.affiliation: Department of Family Medicine and Community Health, University of Miami Miller School of Medicine, Miami, FL USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Konefal
authors.affiliation: Department of Kinesiology and Sport Sciences, University of Miami, Miami, FL USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Adwan
authors.affiliation: Department of Biology, Miami-Dade College, Miami, FL USA.
authors.forename: Lynell A
authors.initials: LA
authors.lastname: Martinez
authors.affiliation: Department of Biology, Miami-Dade College, Miami, FL USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Villabona
authors.affiliation: Department of Dietetics, Florida International University, Miami, FL USA.
authors.forename: Johanna
authors.initials: J
authors.lastname: Lopez
authors.affiliation: Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL USA.
authors.forename: Stacy
authors.initials: S
authors.lastname: Cutrono
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Miami, FL 33136 USA.
authors.forename: Syed Muhammad Ahsan
authors.initials: SM
authors.lastname: Mehdi
authors.affiliation: Department of Medicine, University of Miami Miller School of Medicine, Miami, FL USA.
authors.forename: Allan
authors.initials: A
authors.lastname: Rodriguez
authors.affiliation: Department of Medicine, University of Miami Miller School of Medicine, Miami, FL USA.
authors.forename: Judi M
authors.initials: JM
authors.lastname: Woolger
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Miami, FL 33136 USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Lewis
keywords: HIV; HbA1c; Low SES; Metabolic syndrome; Sugar consumption