Standardized comparison of cardiovascular risk factors prevalence in Spanish women and men living with HIV and in the general population

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Camps-Vilaro ◽  
S Perez-Fernandez ◽  
R Teira ◽  
V Estrada ◽  
P Domingo ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spain’s Ministry of Science and Innovation (Madrid, Spain), co-financed with European Union European Regional Development Funds –ERDF- [CIBERCV CB16/11/00229]; the Health Department of the Generalitat de Catalunya (Barcelona, Spain) through the Agència de Gestió d’Ajuts Universitaris de Recerca de Catalunya (AGAUR) (Barcelona, Spain) [2017SGR222]. OnBehalf DARIOS and VACH investigators Background People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared age-standardized prevalence and management of CV risk factors in PLWH to that of general population in Spain. Methods Blood pressure, lipid, glucose and anthropometric profile were cross-sectionally compared along with treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations by gender.  Results We included 39,598 individuals aged 35 to 74 years: 28,360 from the general population cohort and 11,238 from the PLWH cohort. Compared to general population, PLWH had a higher concentration of triglycerides (>35mg/dL in women and >26mg/dL in men), and a higher prevalence of metabolic syndrome (>10% and >7.8%) and diabetes (>8.5% and >5.3%) (Table). The proportion of treated diabetes, dyslipidemia, and hypertension were up to 3-fold lower in both women and men living with HIV than in general population (Table). Conclusions Lipid, gluco-metabolic profiles were significantly worse in PLWH compared to general population. In addition, PLWH were less often treated for diagnosed diabetes, dyslipidemia, and hypertension. CV risk factor standardized prevalence Cardiovascular risk factor WOMEN MEN General population People living with HIV p-Value General population People living with HIV p-Value N = 15,159 N = 2,171 N = 13,201 N = 9,067 Hypertension, % 27.4 (26.7 - 28.0) 24.8 (21.6 - 28.1) 0.136 29.0 (28.2 - 29.7) 22.9 (21.4 - 24.4) <0.001 Treated hypertension, % a 62.7 (60.7 - 64.7) 18.9 (13.5 - 24.4) <0.001 59.3 (57.5 - 61.1) 24.1 (21.0 - 27.1) <0.001 Triglycerides, mg/dL b 99 (99 - 100) 134 (134 - 148) <0.001 122 (121 - 122) 148 (148 - 164) <0.001 Total cholesterol, mg/dL 214 (213 - 215) 207 (199 - 215) 0.111 214 (213 - 216) 195 (191 - 198) <0.001 Treated dyslipidaemia, % c 14.0 (13.5 - 14.6) 7.80 (5.60 - 10.0) <0.001 15.1 (14.5 - 15.7) 7.8 (6.8 - 8.7) <0.001 Glucose, mg/dL 97 (96 - 97) 103 (98 - 107) 0.007 104 (103 - 105) 106 (104 - 109) 0.122 Diabetes, % 10.6 (10.1 - 11.1) 19.1 (16.0 - 22.1) <0.001 15.4 (14.8 - 16.0) 20.7 (19.2 - 22.2) <0.001 Treated diabetes, % d 34.4 (31.5 - 37.2) 12.8 (8.00 - 17.5) <0.001 40.0 (37.1 - 42.9) 16.6 (13.9 - 19.3) <0.001 Metabolic Syndrome, % 20.5 (19.8 - 21.1) 31.1 (25.8 - 36.4) <0.001 27.9 (27.1 - 28.7) 35.7 (33.1 - 38.2) <0.001 Values are expressed as mean (95% confidence interval). a Among patients with history of hypertension. b Mean (95% confidence interval) were obtained with log-transformed values. c Among all cohort participants. d Among patients with history of diabetes. HDL-c, high density lipoprotein cholesterol; LDL-c, low density lipoprotein cholesterol

2021 ◽  
Vol 11 (11) ◽  
pp. 1085
Author(s):  
Anna Camps-Vilaró ◽  
Silvia Pérez-Fernández ◽  
Isaac Subirana ◽  
Ramon Teira ◽  
Vicente Estrada ◽  
...  

People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared the age-standardized prevalence and management of CV risk factors in PLWH to that of the general population in Spain. Blood pressure, lipid, glucose, and anthropometric profiles were cross-sectionally compared along with the treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations and stratified by gender. We included 47,593 individuals aged 35 to 74 years, 28,360 from the general population cohort and 19,233 from the PLWH cohort. Compared to the general population, PLWH had a higher concentration of triglycerides (>35 mg/dL in women and >26 mg/dL in men) and a higher prevalence of smoking (>23% and >17%) and diabetes (>9.9% and >8.5%). The prevalence of treated diabetes, hypertension, and dyslipidemia were up to three-fold lower in both women and men living with HIV. There was a significant difference in PLWH compared to the general population in the lipid, glucose, and anthropometric profile. In addition, PLWH were less often treated for diagnosed diabetes, hypertension, and dyslipidemia.


2020 ◽  
Vol 7 (11) ◽  
pp. 1622
Author(s):  
Hamong Suharsono ◽  
Ketut Suryana ◽  
Mochamad P. Pujasakti

Background: Toxoplasma encephalitis (TE) is the most frequent AIDS-related opportunistic infection. T. gondii infects the human population in both developed and developing countries. Toxoplasmosis among PLWHA manifests primarily as a life-threatening condition, TE, brain abscesses and death. Objective was to identify the risk factors of Toxoplasma encephalitis (TE) among people living with HIV/AIDS (PLWHA).  Methods: A case control study was conducted during May to November 2018. The study participants consisted of 90 PLWHA; 30 PLWHA with history of TE (cases) and 60 PLWHA without history of TE (controls). Data such as: socio-demographic, laboratory results, head CT scan findings were collected from the medical record and was analyzed using SPSS version 18.Results: A total of 90 participants PLWHA were enrolled, 30 participants as cases and 60 participants as a control. 49 (54.4%) participants were males and 41 (45.6%) participants were females. Among the risk factors evaluated; the lower lymphocyte level (p=0.016), the lower cluster differentiation (CD) 4 level (p=0.003), no taking highly active antiretroviral therapy (HAART) (p=0.000) were observed to be an independent associated risk factor of TE.Conclusions: Our findings suggest lower lymphocyte levels, lower CD4 count and no taking HAART may constitute a significant associated risk factor for TE in PLWHA.


2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S506-S506
Author(s):  
Folusakin Ayoade ◽  
Dushyantha Jayaweera

Abstract Background The risk of ischemic stroke (IS) is known to be higher in people living with HIV (PLWH) than uninfected controls. However, information about the demographics and risk factors for hemorrhagic stroke (HS) in PLWH is scant. Specifically, very little is known about the differences in the stroke risk factors between HS and IS in PLWH. The goal of this study was to determine the demographics and risk factor differences between HS and IS in PLWH. Methods We retrospectively analyzed the demographic and clinical data of PLWH in OneFlorida (1FL) Clinical Research Consortium from October 2015 to December 2018. 1FL is a large statewide clinical research network and database which contains health information of over 15 million patients, 1240 clinical practices, and 22 hospitals. We compared HS and IS based on documented ICD 9 and 10 diagnostic codes and extracted information about sociodemographic data, traditional stroke risk factors, Charlson comorbidity scores, habits, HIV factors, diagnostic modalities and medications. Statistical significance was determined using 2-sample T-test for continuous variables and adjusted Pearson chi square for categorical variables. Odds ratio (OR) and 95% confidence intervals (CI) between groups were compared. Results Overall, from 1FL sample of 13986 people living with HIV, 574 subjects had strokes during the study period. The rate of any stroke was 18.2/1000 person-years (PYRS). The rate of IS was 10.8/1000 PYRS while the rate of HS was 3.7/1000 PYRS, corresponding to 25.4% HS of all strokes in the study. Table 1 summarizes the pertinent demographic and risk factors for HS and IS in PLWH in the study. Table 1: Summary of pertinent demographic and risk factors for hemorrhagic and ischemic strokes in people living with HIV from One Florida database Conclusion In this large Floridian health database, demographics and risk factor profile differs between HS and IS in PLWH. Younger age group is associated with HS than IS. However, hypertension, hyperlipidemia and coronary artery disease are more likely to contribute to IS than HS in PLWH. Further research is needed to better understand the interplay between known and yet unidentified risk factors that may be contributing to HS and IS in PLWH. Disclosures All Authors: No reported disclosures


2021 ◽  
Vol 34 (2) ◽  
pp. e100247
Author(s):  
Matt Pelton ◽  
Matt Ciarletta ◽  
Holly Wisnousky ◽  
Nicholas Lazzara ◽  
Monica Manglani ◽  
...  

BackgroundPeople living with HIV/AIDS (PLWHA) must contend with a significant burden of disease. However, current studies of this demographic have yielded wide variations in the incidence of suicidality (defined as suicidal ideation, suicide attempt and suicide deaths).AimsThis systematic review and meta-analysis aimed to assess the lifetime incidence and prevalence of suicidality in PLWHA.MethodsPublications were identified from PubMed (MEDLINE), SCOPUS, OVID (MEDLINE), Joanna Briggs Institute EBP and Cochrane Library databases (from inception to before 1 February 2020). The search strategy included a combination of Medical Subject Headings associated with suicide and HIV. Researchers independently screened records, extracted outcome measures and assessed study quality. Data were pooled using a random-effects model. Subgroup and meta-regression analyses were conducted to explore the associated risk factors and to identify the sources of heterogeneity. Main outcomes were lifetime incidence of suicide completion and lifetime incidence and prevalence of suicidal ideation and suicide attempt.ResultsA total of 185 199 PLWHA were identified from 40 studies (12 cohorts, 27 cross-sectional and 1 nested case-control). The overall incidence of suicide completion in PLWHA was 10.2/1000 persons (95%CI: 4.5 to 23.1), translating to 100-fold higher suicide deaths than the global general population rate of 0.11/1000 persons. The lifetime prevalence of suicide attempts was 158.3/1000 persons (95%CI: 106.9 to 228.2) and of suicidal ideation was 228.3/1000 persons (95%CI: 150.8 to 330.1). Meta-regression revealed that for every 10-percentage point increase in the proportion of people living with HIV with advanced disease (AIDS), the risk of suicide completion increased by 34 per 1000 persons. The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the suicide deaths was graded as ‘moderate’ quality.ConclusionsThe risk of suicide death is 100-fold higher in people living with HIV than in the general population. Lifetime incidence of suicidal ideation and attempts are substantially high. Suicide risk assessments should be a priority in PLWHA, especially for those with more advanced disease.


2019 ◽  
Vol 23 (11) ◽  
pp. 2916-2925 ◽  
Author(s):  
Sabeena Sears ◽  
Justin R. Buendia ◽  
Sylvia Odem ◽  
Mina Qobadi ◽  
Pascale Wortley ◽  
...  

2016 ◽  
Vol 64 (4) ◽  
pp. 922.2-923
Author(s):  
H Alkhawam ◽  
M Mariya Fabisevich ◽  
R Sogomonian ◽  
JJ Lieber ◽  
R Madanieh ◽  
...  

BackgroundTobacco abuse and alcohol dependence have been established as risk factors for atherosclerotic heart disease (ASHD). Their potential synergistic effect, however, have not been previously evaluated.Abstract ID: 12 Table 1Alcohol abuse/ DependenceAlcoholic abuse (n=172)Alcoholic- Smoker (n=51)Alcoholic Non-Smoker (n=121)Mean age (years)55.151.156.195% CI(52–58)(48–54.2)(54.6–57.6)Non-Alcohol abuse/DependenceNon-Alcoholic (n=7904)Non-Alcoholic Smoker (n=909)Non-alcoholic Non-smoker (n=6995)Mean age (years)63.856.371.395% CI(63.6–63.9)(55–57.7)(71–71.6)p Value<0.0010.02<0.001Objective/PurposeTo investigate the synergistic role of alcohol abuse/dependence and tobacco use in the early incidence of ACS.MethodsA retrospective chart analyses of 8076 patients diagnosed with ACS between 2000 to 2014, defined by ICD-9 codes for acute MI, alcohol abuse/dependence and tobacco use. Average age of ACS was calculated for the general population. Patients were then divided into 4 subgroups based on alcohol abuse/dependence and tobacco use status as follows: non-alcoholic non-smokers, non-alcoholic smokers, alcoholic non-smokers and alcoholic smokers.ResultsThe mean age of our 8076 ACS patients population was ∼59.5 (95% CI 59.2–59.8). Patients with history of alcohol abuse/dependence appeared to develop ACS ∼8.7 years younger than their non-alcoholic counterparts. When tobacco use is incorporated as a risk factor, those with both alcohol abuse/dependence and tobacco use seemed to develop ACS ∼5 years earlier than those with history of either alone, and ∼20 years earlier when compared to those with neither alcohol abuse/dependence nor tobacco use.(table 1 summarizes mean age of ACS incidence in our study subgroups).ConclusionsAlcohol abuse/dependence appears to be a risk factor for earlier ACS. In our population, the average age of ACS incidence in alcoholic patients was significantly earlier than non-alcoholic patients. Furthermore, alcoholic patients who also used tobacco developed ACS at an even younger age when compared to those who had history of either alcohol abuse/dependence or tobacco use alone, suggesting a possible synergistic effect of these two risk factors in developing early ACS. Healthcare intervention in this population through screening, counseling and education regarding alcohol abuse/dependence and smoking cession is warranted to reduce early ACS.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Melissa Orlandin Premaor ◽  
Gabriela Caeran ◽  
Luciana Almeida ◽  
Jose Carvalho ◽  
Carolina Stein ◽  
...  

Abstract The life expectancy of people living with HIV (PLHIV) increased considerably after the advent of antiretroviral therapy (ARV). Nowadays, it is almost the same as the general population. However, this increase in survival exposes PLVH to age-related morbidities, including chronic metabolic and bone diseases. PLHIV has a low bone mineral density (BMD) and a high prevalence of osteoporosis. Moreover, the frequency of diabetes mellitus (DM) seems to be twice the frequency of the general population. Insulin resistance and DM might be associated with bone diseases in PLHIV. Our study aim was to evaluate the association between insulin resistance and osteoporosis in PLHIV. We carried out a cross-sectional study at the municipality of Santa Maria, South Brazil. PLHIV age 50 yrs or over on treatment with ARV were included. All subjects registered to receive ARV in the university hospital during the period 2016 to 2018 were invited to participate. Those who accepted responded to a standardized questionnaire, performed a bone density scan and a lateral spinal X-ray, underwent peripheral blood collection, and had their weight and height measured. Insulin resistance was considered present when HOMA-IR&gt; 2.7 (Gelonese, 2009). The TyG index was also calculated (VASQUES, 2011). Of the 101 PLHIV who agreed to participate, 84 underwent both insulin and BMD measurements. The prevalence of osteoporosis was 19%. Vertebral fractures were twice as frequent in individuals with osteoporosis (73.3% vs. 36.5%, p = 0.018). Participants with osteoporosis had lower BMI and triglyceride values than those without it. The frequency of insulin resistance calculated by HOMA-IR was 68.2%, and it was associated with glucocorticoid use, smoking, and BMI. HOMA-IR [4.8(6.6) vs. 8.68(9.6), p =0.013], and TyG [5.0(0.3) vs. 5.2 (0.4), p=0.029] mean values were lower in the group with osteoporosis; however, this association disappeared after correction for BMI in the logistic regression model. In conclusion, in our study, PLHIV with osteoporosis have lower insulin resistance than PLHIV without it. Nevertheless, this finding appears to be relating to a lower BMI. Further studies are needed to assess the effect of insulin resistance on fracture risk in PLVH. GELONEZE, B. et al. HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome: Brazilian Metabolic Syndrome Study (BRAMS). Arq Bras Endocrinol Metabol. 2009 Mar;53(2):281-7 VASQUES, A. C. et al. Análise Crítica do Uso dos Índices do Homeostasis Model Assessment (HOMA) na Avaliação da Resistência à Insulina e Capacidade Funcional das Células-C Pancreáticas. Arq. Bras. Endocrinol. Metab., 2008;52/1:32-39.


Author(s):  
Qun Wang ◽  
Sek Ying Chair ◽  
Eliza Mi-Ling Wong ◽  
Ruth E. Taylor-Piliae ◽  
Xi Chen Hui Qiu ◽  
...  

Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors. Many people may be unaware of their risk for MetS. A cross-sectional, descriptive study was conducted among hospitalized patients with at least one cardiometabolic risk factor in Mainland China. This study assessed the MetS knowledgelevel(through MetS Knowledge Scale, MSKS) and examined the potential predictors by regression analysis. A total of 204 patients aged 58.5 ± 10.1 years (55% males) participated in this study. The majority of participants had no history of hypertension (54%), dyslipidemia (79%), or diabetes (85%). However, 56% of these participants had at least three cardiometabolic risk factors, indicating the presence of MetS. The average MSKS was very low (mean = 36.7±18.8, possible range = 0–100), indicating the urgent needs of MetS education in current practice. Predictors of better MetS knowledge included higher educational level, history of dyslipidemia, and normal high-density lipoprotein cholesterol (F (8, 195) = 9.39, adjusted R2 = 0.192, p< 0.001). In conclusion, adults with cardiometabolic risk factors are at risk of developing MetS, but with a low level of knowledge. Specific health education on MetS should be provided, particularly for those with limited formal education or inadequate lipid management.


2019 ◽  
Vol 10 (2) ◽  
pp. 26-30
Author(s):  
Vivek Sinha ◽  
Poonam Kachhawa

Background: Gestational diabetes mellitus (GDM) is a common medical condition that complicates pregnancies..Gestational diabetes mellitus (GDM) is a diabetic metabolic disorder that occurs in 4% of all pregnant women and 14% of ethnic groups with more prevalence of type II diabetes. It can be defined as increased or abnormal insulin resistance, decreased insulin sensitivity or glucose intolerance with first diagnosis during pregnancy. Aims and Objectives: The purpose of this study was to evaluate the diagnostic screening value of the HbA1c, prevalence of GDM and associated risk factors. Materials and Methods: The study was conducted at the metabolic clinic; in the department of Biochemistry located at SIMS, Hapur. A semi-structured pretested questionnaire was used for data collection. Following the DIPSI guidelines, patients with plasma glucose values >140 mg/dl were labeled as GDM. Statistical methods used were OR (CI95%), percentage, Chi square. Results: Out of 500, 6.72% had GDM. Among all GDM patients, 64.71% had age more than 30 years, 70.59% had BMI more than 25, 41.18% had gravida more than 3 and p- value was significant with regard to age and BMI. P value was found to be significant for risk factors namely positive family history of Diabetes Mellitus, history of big baby and presence of more than one risk factor. Conclusion: GDM is associated with high BMI, early pregnancy loss, family history of DM and previous history of big baby and there could be more than one risk factor. Thus universal screening followed by close monitoring of the pregnant women for early detection of GDM may help improving maternal and fetal outcomes.


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