Factors Associated with Metabolic Syndrome in Middle-aged Women with and without HIV

Abstract

Objective: This study investigated if metabolic syndrome was associated with HIV infection. To evaluate the prevalence of metabolic syndrome (MetS) and associated factors in middle-aged women with and without human immunodeficiency virus (HIV). Design: This cross-sectional study included 273 HIV-infected and 264 HIV-negative female outpatients aged 40-60 years. MetS was diagnosed as having a waist circumference ≥80 cm and two ormore of the following: triglyceride ≥150 mg/dL, high density lipoprotein cholesterol <50 mg/dL, systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg, and blood glucose ≥100 mg/dL. Sociodemographic, clinical, and behavioral factors were evaluated. Results: The prevalence of MetS in the HIV group was 46.9% compared with 42.2% in the seronegative group (P=0.340). MetS was more prevalent in the HIV group in postmenopausal women (P=0.032), in women taking hormone therapy (P=0.040), in women with excellent/good self-related health (P=0.011), and in women with body mass index (BMI) > 25 kg/m2 (P=0.005). In the 273 patients with HIV, 91% were taking HAART, and approximately 74% had a nadir CD4 above 200/mm3. The main risk factor for acquisition of the infection was heterosexual transmission, the mean duration of infection was 9.9 years, and the mean duration of therapy was 9.4 years. Overall, multiple regression analysis showed MetS was associated with BMI > 25 kg/m2 (prevalence ratio (PR): 2.34; 95% confidence interval (CI): 1.70-3.21; P<0.001), aging (PR: 0.05, 95% CI: 1.02-1.07; P<0.001), and the use of highly active retroviral therapy (HAART) (PR: 1.48; 95% CI: 1.13-1.94; P=0.005). Conclusion: The HIV-positive group had good immunological status as demonstrated by viral suppression and high CD4 levels. However, HIV-positive women who were postmenopausal or had a high BMI showed a significantly higher prevalence of MetS. Overall, the main factors associated with MetS were use of HAART, being overweight, and aging. There is a need for a better approach, awareness, and education of both HIVpositive and HIV-negative women to prevent weight gain and MetS. For HIV-positive middle-aged women, choosing effective HAART with fewer adverse effects on metabolism is an important aspect to prevent MetS. This should be considered in clinical practice to reduce the risk of MetS in this population. Multiple regression analysis of the variables associated with the presence of metabolic syndrome in the total sample -HIV positive and negative women [n=537 (a)]. (Table Presented).