Screening for metabolic syndrome in HIV-infected adults recommended

Freitas P. BMC Infect Dis. 2011;doi:10.1186/1471-2334-11-246.

Researchers in Portugal observed a high prevalence of metabolic syndrome among HIV-infected adults and said this may explain why these patients are at increased risk for cardiovascular disease.

“All HIV-infected patients on combination antiretroviral therapy (ART) must be screened for metabolic syndrome,” Paula Freitas, MD, of the University of Porto Medical School in Portugal, said in an interview. “Lifestyle changes — stop smoking, increase physical activity and improve food habits — must be offered to these patients, and all metabolic abnormalities must be treated according to the guidelines.”

In the cross-sectional study, Freitas and colleagues assessed the prevalence of metabolic syndrome among HIV-infected adults on combination ART (n=345). The median age of the patients was 40 years. Researchers further assessed whether patients with or without clinical lipodystrophy had a different prevalence of metabolic abnormalities, such as abdominal obesity, hyperglycemia, hypertension, high triglycerides or low HDL levels.

Overall, 58.7% of patients had clinical lipodystrophy. The prevalence of metabolic syndrome, according to the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults criteria, was 52.2%; it was 43.2%, based on the International Diabetes Federation criteria. The prevalence for metabolic syndrome did not significantly differ between patients with or without clinical lipodystrophy.

Compared with those without clinical lipodystrophy, patients with the condition had a significantly higher risk for coronary heart disease at 10 years. Higher frequencies of moderate and high-risk categories were observed in those with both clinical lipodystrophy and metabolic syndrome vs. those without metabolic syndrome.

Further, the researchers found that clinical lipodystrophy was significantly associated with metabolic syndrome, hypertriglyceridemia, low HDL, combination ART and BMI in women. In male patients, high blood pressure, high-waist circumference and metabolic syndrome were more frequent in those with isolated central fat accumulation and mixed forms of clinical lipodystrophy. – by Ashley DeNyse

Disclosure: This research was funded by research fellowship Dr. Manuel Almeida Ruas, Portuguese Society of Diabetology, research fellowship of the Portuguese Association for Clinical Study of AIDS, and a research grant to support doctoral studies in the area of HIV/AIDS Foundation GlaxoSmithKline of Health Sciences.

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