Investigation of metabolic syndrome among people living with HIV: insight from a comparative study

Abstract

Purpose This study aims to investigate the prevalence of metabolic syndrome (MetS) among people living with HIV (PLWHIV) considering a comparative study. Design/methodology/approach A comparative cross-sectional study was carried out with 247 respondents which include 123 HIV patients and 124 people without HIV (PWoH) recruited using a simple random sampling method. Anthropometric measurements were taken using the standard procedures and instruments. Systolic and diastolic blood pressure was measured in all the subjects. The lipid level and blood glucose were obtained using a vacutainer method to collect at least 5 ml of venous blood into a heparin-containing bottle and fluoride bottle, and a chemical pathology analysis was conducted at the pathology laboratory. Findings Using the International Diabetes Federation criteria, the overall prevalence of MetS was 21.1%, while 27.6% and 14.5% prevalence were observed among the PLWHIV and PWoH, respectively. In all, 4% of the respondents were underweight, 40.9% had normal body mass index, 29.6 were overweight and 18.6 were obese I. The mean total cholesterol and triglycerides (TG) for PLWHIV and controls were 162.59 ± 37.80, 177.54 ± 34.23, 91.62 ± 51.74 and 69.59 ± 33.87 mg/dl, respectively. There was no significant association between gender and MetS. Of all the determinants of MetS, central obesity has the highest prevalence (71.5%, 65.3%) among the PLWHIV and the controls. Raised TGs were the components of MetS with the least prevalence (9.8% and 4.8%) among PLWHIV and PWoH. There was a significant association between reduced high-density lipoprotein cholesterol (HDL-C) (p = 0.001) and raised blood pressure (p = 0.001) of PLWHIV and PWoH. This study reveals that the burden of MetS among PLWHIV is higher than apparently healthy individuals. Research limitations/implications This study could not measure the association between specific antiretroviral therapy (ART) regimens and MetS because all the PLWHIV in the study are on one regimen Tenofovir disoproxil/lamivudine/dolutegravir. Therefore, longitudinal studies on the extent of ART on MetS should be carried out while using newly diagnosed HIV patients who are not yet on ART as controls. Practical implications Prevalence of MetS and its components toward the high range among PLWHIV compared to the PWoH who are apparently healthy individuals was found. Higher prevalence of central obesity and reduced HDL-C among PLWHIV was also found. Overall, MetS is high among PLWHIV, and this might predispose them to adverse metabolic diseases such as cardiovascular diseases, diabetes and kidney diseases among others. Therefore, screening for metabolic risk factors should be adopted as part of routine HIV care. Originality/value The findings reveal the magnitude of MetS among PLWHIV compared to the apparently healthy individuals.