Prevalence and risk factors of metabolic syndrome in Ethiopia: describing an emerging outbreak in HIV clinics of the sub-Saharan Africa - a cross-sectional study.
Prevalence and risk factors of metabolic syndrome in Ethiopia: describing an emerging outbreak in HIV clinics of the sub-Saharan Africa - a cross-sectional study.
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DOI：
10.1136/bmjopen-2022-069637
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发表时间：
2023-12-09
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
作者：
hiv诱导的慢性炎症、免疫激活和抗逆转录病毒联合治疗（cART）与已知引起心血管逆境的不良代谢变化有关。本研究评估了脂肪营养不良和代谢综合征（MetS）的患病率，并分析了服用cART的艾滋病毒感染埃塞俄比亚人的危险因素。在三级医院进行了一项多中心横断面研究。在HIV诊所登记了符合条件的参与者。研究了社会人口统计学、人体测量学、临床、HIV治疗变量、血脂、空腹血糖水平、危险因素和MetS成分，以及脂肪营养不良。数据分析采用SPSS V.25统计软件包，采用描述性统计和分析性统计。多变量风险因素分析采用logistic回归模型。结果以频率和百分比、平均值±SD或中位数+IQR表示。p<0.05为差异有统计学意义。在518名研究参与者中，三分之二是女性，研究人群的平均年龄为45岁（SD=11）。cART的平均持续时间为10年（SD=4）。中位CD4计数为460个细胞/mm3。根据成人治疗小组III（2005）标准，met的患病率为37.6%。在多变量分析中，met的独立危险因素为年龄bb ~ 45岁（aHR 1.8, 95% CI 1.2 ~ 2.4）、女性（aHR 1.8, 95% CI 1.1 ~ 2.8）、体重指数（BMI） bb ~ 25 kg/m2 （aHR 2.7, 95% CI 1.8 ~ 4.1）、依非韦伦基cART （aHR 2.8, 95% CI 1.6 ~ 4.8）和洛匹那韦/利托那韦基cART （aHR 3.7, 95% CI 1.0 ~ 13.3）。脂肪营养不良的患病率为23.6%。先前暴露于含司他夫定的方案与脂肪营养不良独立相关（aHR 3.1, 95% CI 1.6 - 6.1）。我们的研究显示，38%的参与者有MetS，这表明有相当大的心血管疾病风险。MetS的独立危险因素是BMI≥25kg /m2，依非韦伦和洛匹那韦/利托那韦为基础的cART，女性和年龄≥45岁。除了预防之外，心血管疾病风险分层和管理将降低艾滋病毒感染者的发病率和死亡率。
HIV-induced chronic inflammation, immune activation and combination antiretroviral therapy (cART) are linked with adverse metabolic changes known to cause cardiovascular adversities. This study evaluates the prevalence of lipodystrophy, and metabolic syndrome (MetS), and analyses risk factors in HIV-infected Ethiopians taking cART. A multicentre cross-sectional study was conducted at tertiary-level hospitals. Eligible participants attending the HIV clinics were enrolled. Sociodemographic, anthropometric, clinical, HIV treatment variables, lipid profile, fasting blood glucose level, risk factors and components of MetS, also lipodystrophy, were studied. Data were analysed by SPSS statistical package V.25 with descriptive and analytical statistics. For multivariable analysis of risk factors, a logistic regression model was used. Results were presented in frequency and percentages, mean±SD, or median+IQR. Statistical significance was taken as p<0.05. Among 518 studied participants, two-thirds were females, and the mean age of the study population was 45 years (SD=11). The mean duration of cART was 10 years (SD=4). Median CD4 count was 460 cells/mm3. The prevalence of MetS according to the Adult Treatment Panel III (2005) criteria was 37.6%. In multivariable analysis, independent risk factors for MetS were age >45 years (aHR 1.8, 95% CI 1.2 to 2.4), female sex (aHR 1.8, 95% CI 1.1 to 2.8), body mass index (BMI)>25 kg/m2 (aHR 2.7, 95% CI 1.8 to 4.1), efavirenz-based cART (aHR 2.8, 95% CI 1.6 to 4.8) and lopinavir/ritonavir-based cART (aHR 3.7, 95% CI 1.0 to 13.3). The prevalence of lipodystrophy was 23.6%. Prior exposure to a stavudine-containing regimen was independently associated with lipodystrophy (aHR 3.1, 95% CI 1.6 to 6.1). Our study revealed 38% of the participants had MetS indicating considerable cardiovascular disease (CVD) risks. Independent risk factors for MetS were BMI≥25 kg/m2, efavirenz and lopinavir/ritonavir-based cART, female sex and age ≥45 years. In addition to prevention, CVD risk stratification and management will reduce morbidity and mortality in people with HIV infection.
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影响因子：
5.2
作者：
Calza, L;Manfredi, R;Chiodo, F
通讯作者：
Chiodo, F
影响因子：
6.1
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Villarroya, Francesc
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作者：
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影响因子：
3.7
作者：
Gleason RL Jr;Caulk AW;Seifu D;Parker I;Vidakovic B;Getenet H;Assefa G;Amogne W
通讯作者：
Amogne W