ABSTRACT
Objectives@#People living with HIV (PLHIV) are susceptible to develop dyslipidemia and hyperglycemia. This study aims to determine the prevalence of these metabolic derangements among Filipino PLHIV.@*Methodology@#We reviewed 635 medical records in a treatment hub in Manila, Philippines from January 2004 to July 2016. Logistic regression analysis was done to determine factors associated with dyslipidemia and hyperglycemia pre- and post-ART.@*Results@#Among 635 PLHIV, 97.3% were males with mean age of 30 years and median CD4 count of 207 cells/mm3. Pre-ART, prevalence of dyslipidemia was 65.4% and hyperglycemia was 10.4%. Risk factors for dyslipidemia include hyperglycemia (AOR 3.8, p 0.001) and >320 days delay in ART initiation from HIV confirmation (AOR 1.5, p 0.032), while dyslipidemia was associated with hyperglycemia (AOR 3.1, p 0.001). Post-ART, prevalence of dyslipidemia was 48.6% and hyperglycemia was 15.6%. Risk factors for post-ART dyslipidemia include being WHO stage 4 (AOR 2.1, p 0.021), hyperglycemia (AOR 16.1, p<0.001), >36 months ART duration (AOR 8.7, p<0.001) and efavirenz-based ART (AOR 2.8, p<0.001). Low CD4 count post-ART had a negative correlation with dyslipidemia (AOR 0.5, p 0.005). Post-ART hyperglycemia was associated with age >30 years (AOR 2.1, p 0.004), being overweight (AOR 1.8, p 0.023), dyslipidemia (AOR 17.8, p<0.001) and zidovudine-based ART (AOR 1.4, p 0.051).@*Conclusion@#Dyslipidemia and hyperglycemia prevalence was high in Filipino PLHIV. Traditional, HIV and treatment related factors contributed to its development. Intensive monitoring and initiation of appropriate treatment is recommended.
Subject(s)
HIV , Acquired Immunodeficiency Syndrome , Dyslipidemias , HyperglycemiaABSTRACT
Objective@#This study aimed to estimate the prevalence of cardiovascular risk factors and metabolic syndrome among community health workers (CHWs) in selected villages in the Philippines. It also determined the association of urbanization and socio-demographic characteristics with hypertension, diabetes mellitus and metabolic syndrome among CHWs.@*Methodology@#A cross-sectional study was conducted among CHWs who were actively rendering service from selected communities at the time of the study. Standardized interviews were conducted and clinical measurements were collected.@*Results@#Of the total of 457 CHWs who participated, 96% were females with a median age of 50 years. The prevalence of hypertension in this population was 32.4%. Hypertension was found to be associated with older age [adjusted odds ratio (aOR) 5.3, 95% CI: 3.2 to 8.8, p<0.001], obesity (aOR 2.4, 95% CI: 1.4 to 4.0, p=0.002) and alcohol consumption (aOR 1.7, 95% CI: 1.0 to 3.0, p<0.040). The prevalence of diabetes mellitus (DM) was 13.6%. It was found to be more prevalent among CHWs who were at least 50 years old (aOR 2.7, 95% CI: 1.4 to 5.1, p=0.002), and those who spent at least 5 hours a day in sedentary activities (aOR 3.8, 95% CI: 1.1 to 12.7, p<0.033). Borderline to high total cholesterol, low density lipoprotein cholesterol (LDL-c) and triglycerides (TG) were seen in 41%, 37% and 20%, respectively. Sixty percent had low high density lipoprotein cholesterol (LDL-c). The overall prevalence of metabolic syndrome was 52.3%.@*Conclusion@#Metabolic syndrome is prevalent among CHW participants, with obesity, hypertension and low LDL-c as the most common components present. The prevalence of cardiovascular risk factors in this population was not found to be significantly different between rural and urban areas after adjusting for other factors.