| Autor: |
Masyuko SJ; Ministry of Health, Nairobi, Kenya.; Department of Global Health., Page ST; Department of Global Health.; Department of Medicine, University of Washington, Seattle, WA., Kinuthia J; Department of Research and Programs, Kenyatta National Hospital., Osoti AO; Department of Global Health.; Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya., Polyak SJ; Department of Laboratory Medicine, University of Washington, Seattle, WA., Otieno FC; Department of Clinical Medicine and Therapeutics, College of Health Sciences, University of Nairobi, Nairobi, Kenya., Kibachio JM; Ministry of Health, Nairobi, Kenya., Mogaka JN; Department of Medicine, University of Washington, Seattle, WA., Temu TM; Department of Global Health., Zifodya JS; Departments of Medicine, Tulane University, New Orleans, LA., Otedo A; Ministry of Health, Nairobi, Kenya., Nakanjako D; Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda., Hughes JP; Department of Biostatistics., Farquhar C; Department of Global Health.; Department of Medicine, University of Washington, Seattle, WA.; Department of Epidemiology, University of Washington, Seattle, WA. |
| Abstrakt: |
To determine the prevalence and correlates of metabolic syndrome (MetS) and compare 10-year cardiovascular disease (CVD) risk among Kenyan adults with and without HIV infection.We conducted a cross-sectional study among adults ≥30 years of age with and without HIV infection seeking care at Kisumu County Hospital. Participants completed a health questionnaire and vital signs, anthropomorphic measurements, and fasting blood were obtained. MetS was defined using 2009 Consensus Criteria and 10-year Atherosclerotic CVD (ASCVD) risk score was calculated. Chi-square, independent t tests, Wilcoxon ranksum test and multivariable logistic regression were used to determine differences and associations between HIV and MetS, CVD risk factors and ASCVD risk score.A total of 300 people living with HIV (PLWHIV) and 298 HIV-negative participants with median age 44 years enrolled, 50% of whom were female. The prevalence of MetS was 8.9% overall, but lower among PLWHIV than HIV-negative participants (6.3% vs 11.6%, respectively; P = .001). The most prevalent MetS components were elevated blood pressure, decreased high density lipoprotein, and abdominal obesity. Adjusting for covariates, PLWHIV were 66% less likely to have MetS compared to HIV-negative participants (adjusted odds ratio [aOR] 0.34; 95% confidence interval [95%CI] 0.18, 0.65; P = .005). Median ASCVD risk score was also lower among PLWHIV compared to HIV-negative participants (1.7% vs 3.0%, P = .002).MetS was more common among HIV-negative than HIV-positive adults, and HIV-negative adults were at greater risk for CVD compared to PLWHIV. These data support integration of routine CVD screening and management into health programs in resource-limited settings, regardless of HIV status. |
