Lipid accumulation product index to predict metabolic syndrome in people living with hiv

Abstract

Background: Dyslipidemia and central obesity are the main components of metabolic syndrome, which represent important risk factors for cardiovascular diseases in people living with human immunodeficiency virus (HIV). The lipid accumulation product (LAP) index has been shown in studies as an efficient marker of metabolic syndrome in general adult population and its applicability in HIV-infected population is not discussed. We aimed to assess the accuracy of the LAP index to identify metabolic syndrome in people living with HIV. Methods: It is a cross-sectional study with 141 HIV-infected patients on antiretroviral therapy, conducted in a reference centre of infectious diseases in southeast Brazil. Evaluations included LAP index, anthropometric measurements and clinical and laboratorial variables. Metabolic syndrome was defined by International Diabetes Federation (IDF) criteria. Results: The prevalence of metabolic syndrome in our sample was 10.6%. A positive and significant correlation was found between the metabolic syndrome and LAP (r=0.401; P<0.01), metabolic syndrome and body mass index (r=0.361; P<0.01) and metabolic syndrome and waist circumference (r=0.427; P<0.01) in our sample. The analysis of the receiver-operating characteristic (ROC) curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 59.4 (sensitivity 80%, specificity 79% and area under the curve (AUC) of 0.875. In female and male, analysis of the ROC curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 56.3 (sensitivity 100%, specificity 82% and AUC of 0.929) and 52.0 (sensitivity 78%, specificity 74% and AUC of 0.838), respectively. Conclusion: Despite the low prevalence of metabolic syndrome in our sample, the ROC curves analyzes demonstrated a good diagnostic accuracy as an additional screening tool of metabolic syndrome according to the IDF.