title: Metabolic Syndrome in Children and Adolescents Living with HIV.
abstract: Metabolic syndrome (MetS) is considered an independent risk factor for developing cardiovascular disease. It is well known that the prevalence of metabolic disorders have increased in pediatric HIV-infected children. The objective of this study is to assess the prevalence and characteristics of MetS in HIV-infected children and adolescents in Spain.
  
  
  
  A cross-sectional multicenter study in 152 patients from the pediatric cohort of the Spanish AIDS Research Network (CoRISpe) was performed. MetS was defined according to the new International Diabetes Federation (IDF) diagnostic criteria and the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Measurements included anthropometry, waist circumference, blood pressure, fasting lipids, glucose and insulin and lipodystrophy assessment. Demographic, clinical, immunological, virological and antiretroviral therapy data were obtained from the Network database.
  
  
  
  An abnormally low high-density lipoprotein-cholesterol level was the most prevalent disturbance (21.05%) found. Three patients met IDF criteria for MetS (1.97%), and MetS was significantly associated with lipohypertrophy (P=0.029) in the analysis. When the modified NCEP-ATP III criteria were used, the prevalence of MetS was 5.92% (9 patients), and MetS was significantly associated with Tanner stage ≥2 (P=0.041), lipohypertrophy (P=0.001) and higher Z scores for weight and body mass index (P=0.002 and P<0.001). Insulin resistance was observed in 17 patients (11.18%) and was associated with MetS (as per the modified NCEP-ATP III criteria) (P=0.03) and lower high-density lipoprotein-cholesterol values (P=0.036).
  
  
  
  The prevalence of MetS in our cohort was 1.97% or 5.92%, depending on the diagnostic criteria used. MetS should be actively assessed, particularly in children who show lipohypertrophy.
authors.affiliation: From the *Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron-Universitat Autònoma de Barcelona, Barcelona, Spain; †Pediatric Endocrinology Unit, Department of Pediatrics, Hospital Universitari Vall d'Hebron-Universitat Autònoma de Barcelona, Centre for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain; ‡Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu-Universitat de Barcelona, Barcelona, Spain; §Pediatric Infectious Diseases and HIV Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; ¶Department of Pediatric Infectious Diseases and Immunology, Hospital Universitario Virgen del Rocío, Sevilla, Spain; ‖Department of Pediatrics, Hospital Universitari Sant Joan d'Alacant, Alicante, Spain; **Infectious Diseases Unit, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain; ††Infectious and Tropical Diseases Unit, Department of Pediatrics, Hospital Universitario Infantil La Paz-Hospital Carlos III, Madrid, Spain; ‡‡Infectious Diseases Unit, Department of Pediatrics, Hospital Clínico de Zaragoza, Zaragoza, Spain; §§Pediatric Infectious Diseases and HIV Unit, Complejo Hospitalario Insular Materno-Infantil de las Palmas de Gran Canaria, Las Palmas, Spain; ¶¶Infectious Diseases Unit, Department of Pediatrics, Hospital Germans Trias i Pujol, Barcelona, Spain; and ‖‖Infectious Diseases Unit, Department of Pediatrics, Hospital Infantil Universitario Miguel Servet, Zaragoza, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Espiau
authors.forename: Diego
authors.initials: D
authors.lastname: Yeste
authors.forename: Antoni
authors.initials: A
authors.lastname: Noguera-Julian
authors.forename: María I
authors.initials: MI
authors.lastname: González-Tomé
authors.forename: Lola
authors.initials: L
authors.lastname: Falcón-Neyra
authors.forename: César
authors.initials: C
authors.lastname: Gavilán
authors.forename: María L
authors.initials: ML
authors.lastname: Navarro-Gómez
authors.forename: María J
authors.initials: MJ
authors.lastname: Mellado-Peña
authors.forename: Mercedes
authors.initials: M
authors.lastname: Gracia-Casanova
authors.forename: María E
authors.initials: ME
authors.lastname: Colino-Gil
authors.forename: Maria
authors.initials: M
authors.lastname: Méndez
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ciria Calavia
authors.forename: Clàudia
authors.initials: C
authors.lastname: Fortuny
authors.forename: Antonio
authors.initials: A
authors.lastname: Carrascosa
authors.forename: Pere
authors.initials: P
authors.lastname: Soler-Palacín
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D015995:Prevalence; D013030:Spain / Q000453:epidemiology