Cardiometabolic Status of Adults Living with HIV in Colon, Panama

项目总结 在世界范围内，代谢综合征(METS)影响着四分之一的成年人，增加了发病率和死亡率 由于一般原因，特别是由于2型糖尿病(DM2)和心血管疾病(CVD)。 METS正在变得高度流行，尽管它的健康后果很重要，但它仍然得不到充分认识， 诊断不足，治疗不足。随着成年艾滋病毒携带者(ALWH)通过 随着抗逆转录病毒治疗(ART)的进展，流行病学正在向非传染性转变 发病率与普通人群相当或高于普通人群的疾病，如梅毒。的确有 在低和低海拔地区的ALWH中，甲型肝炎的临床、实验室和流行病学数据相当匮乏。 中等收入国家。巴拿马是中等收入国家，艾滋病毒感染率在中部地区最高 美洲排名第三，拉丁美洲排名第三，但不定期跟踪非传染性疾病 在ALWH中。因此，这项研究建议描述以下人群的心脏代谢概况和一年轨迹 在加勒比科隆省的ALWH，并确定社会人口学、实验室和治疗 具有这种效果的版主。作为一项探索性目标，我们还将探讨 在ALWH中预防和治疗Met的基于证据的当地指南，长期目标是制定 一种文化上合适的循证干预措施，用于预防、诊断、治疗和跟踪METs 在巴拿马的ALWH，并将其适应拉丁美洲的其他地区。这种干预必须与基线一起通知 在建立研究和临床的同时，在ALWH中的METS流行病学和危险和保护因素 能力和来自当地主要利益相关者的买入。因此，在本研究中，我们的目标是： 1.估计甲型肝炎的总体患病率和12个月的发展轨迹及其五项诊断标准(即， 腹型肥胖、高甘油三酯血症、降低的高密度脂蛋白胆固醇、高血压和高血糖 巴拿马科隆的ALWH。 2.描述和评估治疗、实验室和社会人口学变量对 巴拿马科隆阿尔茨海默病的患病率和发展轨迹及其五项诊断标准。 3.调整临床和预防性METS指南，为评估实施试行的临床工作流程 在巴拿马科隆的ALWH中实施和治疗甲型肝炎，并评估其可行性、可接受性和可持续性 在ART诊所的当地能力范围内。

PROJECT SUMMARY Worldwide, metabolic syndrome (MetS) affects one-quarter of adults, increasing morbidity and mortality due to general causes and especially due to type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). MetS is becoming hyperendemic and, despite its important health outcomes, it remains underrecognized, underdiagnosed, and undertreated. As adults living with HIV (ALWH) have normalized their lifespan with advancements in antiretroviral therapy (ART), there is an epidemiologic shift towards noncommunicable diseases, such as MetS, with prevalence rates comparable to or higher than the general population. There is considerable paucity of clinical, laboratory, and epidemiologic data on MetS among ALWH in low- and middle-income countries. Panama, a middle-income country, has the highest prevalence rate of HIV in Central America and the third highest in Latin America, but does not routinely keep track of noncommunicable diseases among ALWH. Thus, this study proposes to describe the cardiometabolic profile and 1-year trajectory among ALWH in the Caribbean province of Colón and to determine sociodemographic, laboratory, and therapeutic moderators of such effect. As an exploratory objective, we also will explore the feasibility and sustainability of local, evidence-based guidelines to prevent and treat MetS among ALWH, with the long-term goal of developing a culturally appropriate, evidence-based intervention to prevent, diagnose, treat, and follow-up MetS among ALWH in Panama and adapt it for the rest of Latin America. Such intervention must be informed with the baseline MetS epidemiology and the risk and protective factors among ALWH, while building research and clinical capacity and buy-in from key local stakeholders. Thus, in this study, we aim to: 1. Estimate the overall prevalence and 12-month trajectory of MetS and its five diagnostic criteria (i.e., abdominal obesity, hypertriglyceridemia, reduced HDL cholesterol, hypertension, and hyperglycemia) among ALWH in Colón, Panama. 2. Describe and estimate the overall effect of therapeutic, laboratory, and socio-demographic variables on the prevalence and trajectory of MetS its five diagnostic criteria in ALWH in Colón, Panama. 3. Adapt clinical and preventative MetS guidelines to implement a pilot, clinical workflow for the assessment and treatment of MetS in ALWH in Colón, Panama, and evaluate its feasibility, acceptability, sustainability within the ART Clinic’s local capacity.