Metabolic Syndrome Predicts All-Cause Mortality in Persons with Human Immunodeficiency Virus
journal contributionposted on 2015-08-13, 00:00 authored by Olamide D. Jarrett, Christine A. Wanke, Robin Ruthazer, Ioana Bica, Rita Isaac, Tamsin A. Knox
We examined the association between metabolic syndrome (MS) and its individual defining criteria on all-cause mortality in human immunodeficiency virus (HIV)-infected persons. We used data from 567 HIV-infected participants of the Nutrition for Healthy Living study with study visits between 9/1/2000 and 1/31/2004 and determined mortality through 12/31/2006. MS was defined using modified National Cholesterol Education Program guidelines. Cox proportional hazards for all-cause mortality were estimated for baseline MS status and for its individual defining criteria. There were 83 deaths with median follow-up of 63 months. Baseline characteristics associated with increased risk of mortality were: older age in years (univariate hazard ratio [HR] 1.04, p < 0.01), current smoking (HR 1.99, p = 0.02), current heroin use (HR 1.97, p = 0.02), living in poverty (HR 2.0, p < 0.01), higher mean HIV viral load (HR 1.81, p < 0.01), and having a BMI < 18 (HR 5.84, p < 0.01). For MS and its criteria, only low HDL was associated with increased risk of mortality on univariate analysis (HR 1.84, p = 0.01). However, metabolic syndrome (adjusted HR 2.31, p = 0.02) and high triglycerides (adjusted HR 3.97, p < 0.01) were significantly associated with mortality beyond 36 months follow-up. MS, low HDL, and high triglycerides are associated with an increased risk of mortality in HIV-infected individuals.
Financial support for this study was received from National Institutes of Health (T32A1007438-14, P01DK45734, 1P30DA13868, 1K24 A1055293-05, and UL1RR025752-01) and Lifespan/Tufts/Brown Center for AIDS Research (1P30A142853-106637).
Publisher StatementThis is a copy of an article published in the AIDS Patient Care and STDs © 2013 Copyright Mary Ann Liebert, Inc.; AIDS Patient Care and STDs is available online at: http://www.liebertonline.com.
PublisherMary Ann Liebert