ABSTRACT
Fundamento y objetivo. Estudiar la asociación entre el fenotipo «hipertrigliceridemia-cintura abdominal aumentada» y la presencia de aterosclerosis subclínica en pacientes con infección por el virus de la inmunodeficiencia humana (VIH). Pacientes y método. Estudio transversal. Se consideró fenotipo «hipertrigliceridemia-cintura abdominal aumentada» si la cintura era ≥90cm y los trigliceridos ≥2,0mmol/l (178mg/dl) en varones y ≥85cm y ≥1,5mmol/l (133mg/dl), respectivamente, en mujeres. Se utilizó el grosor de la íntima-media (GIM) carotídeo para detectar la presencia de aterosclerosis subclínica. Resultados. Se analizaron 152 pacientes, de los que 128 (84,2%) recibían tratamiento antirretroviral; el 40,7% con inhibidores de la proteasa y un 38,1% con inhibidores de la transcriptasa inversa no nucleósidos. La prevalencia del fenotipo «hipertrigliceridemia-cintura abdominal aumentada» fue del 23,6% (intervalo de confianza del 95% [IC 95%] 16,8-30,3%). Comparados con los pacientes con cintura y valores de triglicéridos normales, los pacientes con fenotipo «hipertrigliceridemia-cintura abdominal aumentada» tuvieron un mayor riesgo cardiovascular según Framingham (media [DE] de 11,09 [7,6] frente a 3,88 [4], p=0,001) y una mayor probabilidad de presentar lipodistrofia (33,3 frente a 13,7%, p=0,039) y síndrome metabólico (69,4 frente a 1,9%, p<0,001). El GIM estuvo elevado en 21 (13,8%) pacientes. Los factores que se relacionaron de forma independiente con GIM elevado fueron el fenotipo «hipertrigliceridemia-cintura abdominal aumentada» (odds ratio [OR] 4,66, IC 95% 1,05-20,6, p=0,043) y el síndrome metabólico (OR 3,74, IC 95% 1,25-11,23, p=0,018). Conclusiones. El fenotipo «hipertrigliceridemia-cintura abdominal aumentada» es un factor de riesgo de aterosclerosis subclínica en pacientes con infección por VIH y podría constituir un marcador indirecto asociado a la presencia de lipodistrofia, síndrome metabólico y riesgo cardiovascular elevado(AU)
Background and objective. To study the association between hypertriglyceridemic waist phenotype and the presence of subclinical atherosclerosis in human immunodeficiency virus (HIV) infected patients. Patients and methods. Cross sectional study. Hypertriglyceridemic waist phenotype was considered if the waist was ≥90cm and triglycerides ≥2.0mmol/l (178mg/dl) in men and ≥85cm and ≥1.5mmol/L (133mg/dl) in women, respectively. We used the intima-media thickness (IMT) to detect carotid subclinical atherosclerosis. Results. We analyzed 152 patients, of whom 128 (84.2%) were receiving antiretroviral therapy, 40.7% were receiving protease inhibitors and 38.1% were treated with non-nucleoside reverse transcriptase inhibitors. The prevalence of hypertriglyceridemic waist phenotype was 23.6% (95% confidence interval [CI] 16.8-30.3%). Patients with hypertriglyceridemic waist phenotype had higher cardiovascular risk according to the Framingham score (11.09 [7.6] vs 3.88 [4], P=0.001) and lipodystrophy (33.3 vs. 13.7%, P=0.032) and metabolic syndrome (69.4 vs. 1.9%, P<0.001) were more frequent. The IMT was elevated in 21 (13.8%) patients. Hypertriglyceridemic waist phenotype (odds ratio [OR] 4.66 [95%CI 1.05-20.6; P = 0.043]) and metabolic syndrome (OR 3.74 [95%CI 1.25-11.23; P = 0.018]) were independently associated with higher IMT. Conclusions. The hypertriglyceridemic waist phenotype is a risk factor for subclinical atherosclerosis in HIV infected patients and it is useful to detect patients with lipodystrophy, metabolic syndrome and high cardiovascular risk(AU)
Subject(s)
Humans , Hypertriglyceridemia/complications , Waist-Hip Ratio , Atherosclerosis/epidemiology , HIV Infections/complications , Risk Factors , Cardiovascular Diseases/epidemiology , Phenotype , Metabolic Syndrome/epidemiologyABSTRACT
BACKGROUND AND OBJECTIVE: To study the association between hypertriglyceridemic waist phenotype and the presence of subclinical atherosclerosis in human immunodeficiency virus (HIV) infected patients. PATIENTS AND METHODS: Cross sectional study. Hypertriglyceridemic waist phenotype was considered if the waist was ≥90cm and triglycerides ≥2.0mmol/l (178mg/dl) in men and ≥85cm and ≥1.5mmol/L (133mg/dl) in women, respectively. We used the intima-media thickness (IMT) to detect carotid subclinical atherosclerosis. RESULTS: We analyzed 152 patients, of whom 128 (84.2%) were receiving antiretroviral therapy, 40.7% were receiving protease inhibitors and 38.1% were treated with non-nucleoside reverse transcriptase inhibitors. The prevalence of hypertriglyceridemic waist phenotype was 23.6% (95% confidence interval [CI] 16.8-30.3%). Patients with hypertriglyceridemic waist phenotype had higher cardiovascular risk according to the Framingham score (11.09 [7.6] vs 3.88 [4], P=0.001) and lipodystrophy (33.3 vs. 13.7%, P=0.032) and metabolic syndrome (69.4 vs. 1.9%, P<0.001) were more frequent. The IMT was elevated in 21 (13.8%) patients. Hypertriglyceridemic waist phenotype (odds ratio [OR] 4.66 [95%CI 1.05-20.6; P = 0.043]) and metabolic syndrome (OR 3.74 [95%CI 1.25-11.23; P = 0.018]) were independently associated with higher IMT. CONCLUSIONS: The hypertriglyceridemic waist phenotype is a risk factor for subclinical atherosclerosis in HIV infected patients and it is useful to detect patients with lipodystrophy, metabolic syndrome and high cardiovascular risk.
