Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: a systematic review and meta-analysis.
Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: a systematic review and meta-analysis.
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DOI：
10.1093/ije/dyt198
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发表时间：
2013-12
影响因子：
7.7
通讯作者：
African Partnership for Chronic Disease Research (APCDR)
中科院分区：
文献类型：
--
作者：
Dillon DG;Gurdasani D;Riha J;Ekoru K;Asiki G;Mayanja BN;Levitt NS;Crowther NJ;Nyirenda M;Njelekela M;Ramaiya K;Nyan O;Adewole OO;Anastos K;Azzoni L;Boom WH;Compostella C;Dave JA;Dawood H;Erikstrup C;Fourie CM;Friis H;Kruger A;Idoko JA;Longenecker CT;Mbondi S;Mukaya JE;Mutimura E;Ndhlovu CE;Praygod G;Pefura Yone EW;Pujades-Rodriguez M;Range N;Sani MU;Schutte AE;Sliwa K;Tien PC;Vorster EH;Walsh C;Zinyama R;Mashili F;Sobngwi E;Adebamowo C;Kamali A;Seeley J;Young EH;Smeeth L;Motala AA;Kaleebu P;Sandhu MS;African Partnership for Chronic Disease Research (APCDR)
背景撒哈拉以南非洲(SSA)是世界上HIV感染负担最高的地区，心脏代谢性疾病的发病率也在不断上升；然而，在SSA人群中，HIV、抗逆转录病毒治疗(ART)和心脏代谢特征之间的相互关系并没有得到很好的描述。方法通过MEDLINE和EMBASE数据库进行系统回顾和荟萃分析(截至2012年1月)，并与作者直接接触。符合条件的研究提供了SSA中HIV+和HIV-或ART+和ART-亚组中以下一个或多个特征的汇总或个人水平数据：体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、甘油三酯(TGS)和空腹血糖(FBG)或糖化血红蛋白(HbA1c)。信息是在随机效应模型下合成的，主要结果是参与者亚组之间特定特征的标准化平均差异(SMD)。结果共获得49篇已发表研究和3篇未发表研究的数据，共报道29755人。高密度脂蛋白(−0.59；95%可信区间，−0.86至−0.31)、体重指数(SMD，−0.32；95%可信区间，−0.45至−0.18)、收缩压(SMD，−0.40；95%可信区间，−0.55至−0.25)、舒张压(SMD，−0.34；−0.40；95%CI，−0.55至−0.25)、舒张压(SMD，−0.34；95%CI，−0.40；95%可信区间，0.08~0.44)、体重指数(SMD，−0.32；95%CI，−0.45至−0.18)和舒张压(SMD，−0.34；95%可信区间，−0.55至−0.25)和舒张压(SMD，−0.34；95%可信区间，−为0.51，−为0.17)。在HIV感染者中，抗逆转录病毒治疗与较高的低密度脂蛋白(−，0.43；95%CI，0.14~0.72)和高密度脂蛋白(SMD，0.39；95%CI，0.11~0.66)和较低的糖化血红蛋白(SMD，−0.34；95%CI，−0.62至−0.06)相关。来自个体参与者数据分析的完全调整的估计与对大多数性状的汇总估计的荟萃分析是一致的。结论与欧洲血统人群的结果基本一致，这些结果表明SSA中HIV感染者和非感染者的心脏代谢特征存在差异，这种差异可能会被ART治疗所改变。在艾滋病毒负担最重的地区，重要的是澄清这些发现，以可靠地评估监测和管理SSA艾滋病毒感染人群心脏代谢风险的必要性。
Background Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations. Methods We conducted a systematic review and meta-analysis through MEDLINE and EMBASE (up to January 2012), as well as direct author contact. Eligible studies provided summary or individual-level data on one or more of the following traits in HIV+ and HIV-, or ART+ and ART- subgroups in SSA: body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TGs) and fasting blood glucose (FBG) or glycated hemoglobin (HbA1c). Information was synthesized under a random-effects model and the primary outcomes were the standardized mean differences (SMD) of the specified traits between subgroups of participants. Results Data were obtained from 49 published and 3 unpublished studies which reported on 29 755 individuals. HIV infection was associated with higher TGs [SMD, 0.26; 95% confidence interval (CI), 0.08 to 0.44] and lower HDL (SMD, −0.59; 95% CI, −0.86 to −0.31), BMI (SMD, −0.32; 95% CI, −0.45 to −0.18), SBP (SMD, −0.40; 95% CI, −0.55 to −0.25) and DBP (SMD, −0.34; 95% CI, −0.51 to −0.17). Among HIV+ individuals, ART use was associated with higher LDL (SMD, 0.43; 95% CI, 0.14 to 0.72) and HDL (SMD, 0.39; 95% CI, 0.11 to 0.66), and lower HbA1c (SMD, −0.34; 95% CI, −0.62 to −0.06). Fully adjusted estimates from analyses of individual participant data were consistent with meta-analysis of summary estimates for most traits. Conclusions Broadly consistent with results from populations of European descent, these results suggest differences in cardiometabolic traits between HIV-infected and uninfected individuals in SSA, which might be modified by ART use. In a region with the highest burden of HIV, it will be important to clarify these findings to reliably assess the need for monitoring and managing cardiometabolic risk in HIV-infected populations in SSA.
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影响因子：
3.4
作者：
Addo AA;Marquis GS;Lartey AA;Pérez-Escamilla R;Mazur RE;Harding KB
通讯作者：
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