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Metabolic syndrome not linked to CVD risk in people with HIV

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After consideration of the risk from its components, metabolic syndrome was not a predictor of cardiovascular disease in people with HIV.

The researchers examined the relationship of metabolic syndrome, components of metabolic syndrome and CVD among 33,347 people with HIV. To reduce the chance for a high type 1 error rate, they randomly assigned 23,202 participants to a training sample.

Two percent of participants in the training sample had a CVD event, including myocardial infarction (51.9%), stroke (27.9%), angioplasty (12.8%), coronary bypass (4.3%), endarterectomy (0.9%) and CV death (2.2%), according to the study.

Event rates were 3.7 (95% CI, 3.2-4.2) per 1,000 person-years in patients with normal triglyceride levels and no hypertension and 43.3 (95% CI, 25.2-69.3) per 1,000 person-years in patients with diabetes and BMI >30 kg/m² when grouped by metabolic syndrome components. The rate of CVD events was 3.2 (95% CI, 2.7-3.8) per 1,000 person-years in participants with no components of metabolic syndrome vs. those with five components (33.9; 95% CI, 41.0-122.5).

Participants with metabolic syndrome (≥3 components) were almost three times more likely to develop CVD compared with those without metabolic syndrome. After adjustment for components, metabolic syndrome no longer predicted risk for CVD.

During follow-up, the CVD rate increased as the number of metabolic syndrome components increased. Participants with metabolic syndrome during follow-up were 2.4 times more likely than those without metabolic syndrome to develop CVD, according to the study. After adjustment for components, metabolic syndrome no longer predicted CVD risk.

Worm SW. Diabetes Care. 2009;32:474-480.