Cardiometabolic Status of Adults Living with HIV in Colon, Panama

巴拿马结肠州成人艾滋病毒感染者的心脏代谢状况

• 批准号: 10536973
• 负责人: Humberto López Castillo
• 金额: $ 19.9万
• 依托单位: UNIVERSITY OF CENTRAL FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10536973
• 关键词: Acquired Immunodeficiency Syndrome; Adult; Affect; Age; Area; Atherosclerosis; Benchmarking; C-reactive protein; Cardiometabolic Disease; Cardiovascular Diseases; Caribbean region; Caring; Central America; Central obesity; Chronic; Cities; Clinic; Clinical; Clinical Research; Colon; Continuity of Patient Care; Country; Data; Development; Diabetes Mellitus; Diagnosis; Disease; Employment; Epidemiologic Methods; Epidemiology; Ethnic Origin; Evidence based intervention; Fogarty International Center; Gender; General Population; Glycosylated hemoglobin A; Goals; Guidelines; HIV; HIV Infections; HIV diagnosis; Health; Heart failure; High Density Lipoprotein Cholesterol; High Prevalence; Hyperglycemia; Hypertension; Hypertriglyceridemia; Income; Institution; Insurance Coverage; Intervention; Laboratories; Latin America; Life Expectancy; Link; Longevity; Metabolic Diseases; Metabolic syndrome; Modification; Monitor; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Panama; Participant; Persons; Population; Population Heterogeneity; Populations at Risk; Positioning Attribute; Prevalence; Process; Protocols documentation; Provider; Province; Quality of life; Race; Reporting; Research; Research Personnel; Research Priority; Research Project Grants; Research Training; Rest; Risk; Risk Factors; Services; Sex Orientation; Strategic Planning; Stroke; Therapeutic; Therapeutic Effect; Time; Uninsured; United States National Institutes of Health; Veterans; Viral; analytical method; antiretroviral therapy; cardiometabolism; compliance behavior; diagnostic criteria; epidemiologic data; evidence based guidelines; experience; follow-up; health management; interest; low and middle-income countries; mortality; prevent; protective factors; response; scale up; sociodemographic variables; sociodemographics; substance use; systemic inflammatory response

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.

项目摘要 在世界范围内，代谢综合征（MetS）影响四分之一的成年人，增加发病率和死亡率 由于一般原因，特别是由于2型糖尿病（DM2）和心血管疾病（CVD）。 代谢综合征正在成为高流行病，尽管其重要的健康结果，它仍然没有得到充分认识， 诊断不足治疗不足由于成年艾滋病毒感染者（ALWH）的寿命已经正常化， 随着抗逆转录病毒疗法（ART）的进步，流行病学向非传染性疾病转变， 疾病，如代谢综合征，患病率与一般人群相当或高于一般人群。有 在ALWH中，关于MetS的临床、实验室和流行病学数据相当缺乏， 中等收入国家。巴拿马是一个中等收入国家，艾滋病毒流行率在中美洲最高， 美国和拉丁美洲第三高，但没有定期跟踪非传染性疾病 在ALWH。因此，本研究建议描述以下患者的心脏代谢特征和1年轨迹： ALWH在加勒比地区的科隆省，并确定社会人口，实验室和治疗 这种效果的调节器。作为一个探索性的目标，我们还将探讨 当地的，以证据为基础的指南，以预防和治疗ALWH中的MetS，长期目标是开发 一种文化上适当的、以证据为基础的干预措施，以预防、诊断、治疗和随访代谢综合征， ALWH在巴拿马，并调整它为拉丁美洲的其他地区。这种干预必须告知基线， MetS流行病学和ALWH之间的风险和保护因素，同时建立研究和临床 能力和当地主要利益攸关方的支持。因此，在本研究中，我们的目标是： 1.估计MetS的总体患病率和12个月轨迹及其五个诊断标准（即， 腹型肥胖、高脂血症、HDL胆固醇降低、高血压和高血糖）， ALWH在科隆，巴拿马。 2.描述和估计治疗、实验室和社会人口统计学变量对 在巴拿马科隆的ALWH中MetS的五个诊断标准的患病率和轨迹。 3.调整临床和预防性MetS指南，以实施评估的试点临床工作流程 和治疗MetS在ALWH在科隆，巴拿马，并评估其可行性，可接受性，可持续性 在ART诊所的本地能力范围内。