艾滋病毒感染者代谢综合征调查:一项比较研究的启示

Olutosin Phebean Akintola, C. A. Oladoyinbo, David Olayinka Ayedun
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引用次数: 0

摘要

设计/方法/途径 采用简单随机抽样方法,对 247 名受访者进行了横断面比较研究,其中包括 123 名艾滋病毒感染者和 124 名非艾滋病毒感染者(PWoH)。采用标准程序和仪器进行了人体测量。对所有受试者的收缩压和舒张压进行了测量。在病理实验室进行了化学病理分析。研究结果根据国际糖尿病联合会的标准,MetS 的总体患病率为 21.1%,而在 PLWHIV 和 PWoH 中的患病率分别为 27.6% 和 14.5%。4%的受访者体重不足,40.9%的受访者体重指数正常,29.6%的受访者超重,18.6%的受访者肥胖。PLWHIV和对照组的总胆固醇和甘油三酯(TG)平均值分别为(162.59 ± 37.80)、(177.54 ± 34.23)、(91.62 ± 51.74)和(69.59 ± 33.87)毫克/分升。性别与 MetS 之间无明显关联。在 MetS 的所有决定因素中,中心性肥胖在 PLWHIV 和对照组中的发病率最高(分别为 71.5%和 65.3%)。在艾滋病毒携带者和艾滋病患者中,总胆固醇升高是发病率最低(9.8% 和 4.8%)的 MetS 组成部分。在 PLWHIV 和 PWoH 中,高密度脂蛋白胆固醇(HDL-C)降低(p = 0.001)和血压升高(p = 0.001)之间存在明显关联。研究局限性/意义本研究无法测量特定抗逆转录病毒疗法(ART)方案与 MetS 之间的关联,因为本研究中的所有 PLWHIV 均采用一种方案:替诺福韦酯/拉米夫定/多拉曲韦。因此,关于抗逆转录病毒疗法对 MetS 影响程度的纵向研究应该以新诊断出的尚未接受抗逆转录病毒疗法的艾滋病患者为对照。研究还发现,PLWHIV 中中心性肥胖和高密度脂蛋白胆固醇(HDL-C)降低的发病率较高。总体而言,PLWHIV 中的 MetS 偏高,这可能会导致他们患上不良代谢疾病,如心血管疾病、糖尿病和肾脏疾病等。因此,应将代谢风险因素筛查作为常规艾滋病护理的一部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Investigation of metabolic syndrome among people living with HIV: insight from a comparative study
Purpose This study aims to investigate the prevalence of metabolic syndrome (MetS) among people living with HIV (PLWHIV) considering a comparative study. Design/methodology/approach A comparative cross-sectional study was carried out with 247 respondents which include 123 HIV patients and 124 people without HIV (PWoH) recruited using a simple random sampling method. Anthropometric measurements were taken using the standard procedures and instruments. Systolic and diastolic blood pressure was measured in all the subjects. The lipid level and blood glucose were obtained using a vacutainer method to collect at least 5 ml of venous blood into a heparin-containing bottle and fluoride bottle, and a chemical pathology analysis was conducted at the pathology laboratory. Findings Using the International Diabetes Federation criteria, the overall prevalence of MetS was 21.1%, while 27.6% and 14.5% prevalence were observed among the PLWHIV and PWoH, respectively. In all, 4% of the respondents were underweight, 40.9% had normal body mass index, 29.6 were overweight and 18.6 were obese I. The mean total cholesterol and triglycerides (TG) for PLWHIV and controls were 162.59 ± 37.80, 177.54 ± 34.23, 91.62 ± 51.74 and 69.59 ± 33.87 mg/dl, respectively. There was no significant association between gender and MetS. Of all the determinants of MetS, central obesity has the highest prevalence (71.5%, 65.3%) among the PLWHIV and the controls. Raised TGs were the components of MetS with the least prevalence (9.8% and 4.8%) among PLWHIV and PWoH. There was a significant association between reduced high-density lipoprotein cholesterol (HDL-C) (p = 0.001) and raised blood pressure (p = 0.001) of PLWHIV and PWoH. This study reveals that the burden of MetS among PLWHIV is higher than apparently healthy individuals. Research limitations/implications This study could not measure the association between specific antiretroviral therapy (ART) regimens and MetS because all the PLWHIV in the study are on one regimen Tenofovir disoproxil/lamivudine/dolutegravir. Therefore, longitudinal studies on the extent of ART on MetS should be carried out while using newly diagnosed HIV patients who are not yet on ART as controls. Practical implications Prevalence of MetS and its components toward the high range among PLWHIV compared to the PWoH who are apparently healthy individuals was found. Higher prevalence of central obesity and reduced HDL-C among PLWHIV was also found. Overall, MetS is high among PLWHIV, and this might predispose them to adverse metabolic diseases such as cardiovascular diseases, diabetes and kidney diseases among others. Therefore, screening for metabolic risk factors should be adopted as part of routine HIV care. Originality/value The findings reveal the magnitude of MetS among PLWHIV compared to the apparently healthy individuals.
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