title: Dyslipidemia, Diet and Physical Exercise in Children on Treatment With Antiretroviral Medication in El Salvador: A Cross-sectional Study.
abstract: Dyslipidemias are common in HIV-infected children, especially if treated with protease inhibitors, but there are few data on how to treat dyslipidemias in this population. We estimated the dyslipidemia prevalence and its association with treatment, diet and physical exercise in children on antiretroviral treatment at the El Salvador reference center for pediatric HIV care (CENID).
  
  
  
  Information was gathered regarding socio-demographic characteristics, treatment, diet and physical activity of 173 children aged 5-18 years and receiving antiretroviral therapy. Triglycerides, total cholesterol, low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), viral load and CD4 T-lymphocytes were measured. Abnormal concentrations were defined as triglycerides ≥130 mg/dL in 10- to 18-year olds and ≥100 mg/dL in <10-year olds; total cholesterol ≥200 mg/dL; LDL-C ≥130 mg/dL and HDL-C ≤35 mg/dL. We adjusted 4 different multivariate models to assess the independent association of each type of dyslipidemia with protease inhibitors, diet and physical exercise.
  
  
  
  Of the 173 children, 83 (48%) had hypertriglyceridemia and 25 (14.5%) hypercholesterolemia. High LDL-C concentrations were observed in 17 children (9.8%) and low HDL-C in 38 (22%). Treatment with protease inhibitors was significantly associated with hypertriglyceridemia [prevalence ratio (PR) 2.8; 95% confidence interval (CI): 2.0-3.8] and hypercholesterolemia (PR 9.0; 95% CI: 3.6-22.2). Higher adherence to a "high fat/sugar diet" was associated with hypercholesterolemia (PR 1.6; 95% CI: 1.1-2.3) and high LDL-C (PR 1.7; 95% CI: 1.0-2.9). Compared with those exercising <3 times/week, children exercising ≥7 times were less likely to have low HDL-C (PR = 0.4; 95% CI: 0.2-0.7).
  
  
  
  These results suggest that a healthy diet and exercise habits can contribute to controlling some aspects of the lipid profile in this population.
authors.affiliation: From the *University of Trieste, Trieste, Italy; †Institute of Research for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy; ‡Field Epidemiology Training Program, National Center of Epidemiology, Institute of Health Salud Carlos III, Madrid, Spain; §Centro de Excelencia para Niños con Inmunodeficiencias, Children Hospital Benjamin Bloom, El Salvador; ¶National Center of Tropical Medicine, Institute of Health Salud Carlos III, Madrid, Spain; and ‖Food Security Unit, Sustainable Resources Directorate, European Commission Joint Research Centre, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Sonego
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Sagrado
authors.forename: Gustavo
authors.initials: G
authors.lastname: Escobar
authors.forename: Marzia
authors.initials: M
authors.lastname: Lazzerini
authors.forename: Estefanie
authors.initials: E
authors.lastname: Rivas
authors.forename: Rocio
authors.initials: R
authors.lastname: Martín-Cañavate
authors.forename: Elsy
authors.initials: E
authors.lastname: Pérez de López
authors.forename: Sandra
authors.initials: S
authors.lastname: Ayala
authors.forename: Luis
authors.initials: L
authors.lastname: Castaneda
authors.forename: Pilar
authors.initials: P
authors.lastname: Aparicio
authors.forename: Estefanía
authors.initials: E
authors.lastname: Custodio
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D050171:Dyslipidemias / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology*; D004544:El Salvador / Q000453:epidemiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents; D008055:Lipids