The association of menopause with cardiometabolic disease risk factors in women living with and without HIV in sub-Saharan Africa: Results from the AWI-Gen 1 study.

Autor: Chikwati RP; Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: raylton.chikwati@wits.ac.za., Jaff NG; Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: nrj1@mweb.co.za., Mahyoodeen NG; Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: mahyoodeen@yahoo.com., Micklesfield LK; SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: Lisa.Micklesfield@wits.ac.za., Ramsay M; Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: Michele.Ramsay@wits.ac.za., Gómez-Olivé FX; Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: F.Gomez-OliveCasas@wits.ac.za., Mohamed SF; Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya. Electronic address: smohamed@aphrc.org., Choma SSR; Department of Pathology, DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa. Electronic address: solomon.choma@ul.ac.za., George JA; Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; The Diagnostic Innovation Hub (DIH), University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa. Electronic address: Jaya.george@wits.ac.za., Crowther NJ; Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa. Electronic address: nigel.crowther@nhls.ac.za.
Jazyk: angličtina
Zdroj: Maturitas [Maturitas] 2024 Sep; Vol. 187, pp. 108069. Date of Electronic Publication: 2024 Jul 17.
DOI: 10.1016/j.maturitas.2024.108069
Abstrakt: Background: Menopause and HIV are associated with cardiometabolic disease. In sub-Saharan Africa there is a growing population of midlife women living with HIV and a high prevalence of cardiometabolic disease.
Objectives: The aim of this study was to determine whether menopause and HIV were associated with cardiometabolic disease risk factors in a population of midlife sub-Saharan African women.
Study Design: This was a cross-sectional comparison of cardiometabolic disease risk factors between 944 premenopausal women (733 living without HIV and 211 living with HIV) and 1135 postmenopausal women (932 living without HIV and 203 living with HIV) in sub-Saharan Africa.
Main Outcome Measures: Anthropometric and cardiometabolic variables were compared between pre- and postmenopausal women living without HIV and between pre- and postmenopausal women living with HIV and between women living without HIV and women living with HIV.
Results: The prevalence of HIV was 19.9 %. Age at menopause was lower in women living with HIV than in women living without HIV (48.1 ± 5.1 vs 50.9 ± 4.7 years, p < 0.001). Women living with HIV and receiving efavirenz-based antiretroviral therapy had a lower body mass index (BMI), hip circumference, blood pressure and carotid intima media thickness but higher triglyceride levels and insulin resistance than women living without HIV. Antiretroviral therapy-naïve women living with HIV had lower HDL-cholesterol than women living without HIV. In this study, menopause was associated with higher LDL-C levels, regardless of HIV status.
Conclusion: The high prevalence of obesity and related cardiometabolic disease risk factors in these midlife sub-Saharan African women is not related to the menopausal transition. The association of cardiometabolic disease risk factors with HIV and antiretroviral therapy is complex and requires further investigation in longitudinal studies, as does the negative association of age at final menstrual period with HIV.
Competing Interests: Declaration of competing interest The authors declare that they have no competing interest.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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