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

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ..

OBJECTIVES: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:13

Enthalten in:

BMJ open - 13(2023), 12 vom: 09. Dez., Seite e069637

Sprache:

Englisch

Beteiligte Personen:

Abdela, Abdurezak Ahmed [VerfasserIn]
Yifter, Helen [VerfasserIn]
Reja, Ahmed [VerfasserIn]
Shewaamare, Aster [VerfasserIn]
Ofotokun, Ighovwerha [VerfasserIn]
Degu, Wondwossen Amogne [VerfasserIn]

Links:

Volltext

Themen:

2494G1JF75
Diabetes & endocrinology
Efavirenz
HIV & AIDS
JE6H2O27P8
Journal Article
Lipid disorders
Lopinavir
O3J8G9O825
Research Support, N.I.H., Extramural
Ritonavir

Anmerkungen:

Date Completed 16.12.2023

Date Revised 24.01.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1136/bmjopen-2022-069637

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM365617490