High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome

Signe H.Westring Worm; Nina Friis-Møller; Mathias Bruyand; Antonella D'Arminio Monforte; Martin Rickenbach; Peter Reiss; Wafaa El-Sadr; Andrew Phillips; Jens Dilling Lundgren; Caroline Sabin; D:A:D Study Group

doi:10.1097/qad.0b013e328334344e

High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome

Signe H.Westring Worm, Nina Friis-Møller, Mathias Bruyand, Antonella D'Arminio Monforte, Martin Rickenbach, Peter Reiss, Wafaa El-Sadr, Andrew Phillips, Jens Dilling Lundgren, Caroline Sabin, D:A:D Study Group

Department of Immunology and Microbiology

68 Citations (Scopus)

Abstract

Introduction: This study describes the characteristics of the metabolic syndrome in HIV-positive patients in the Data Collection on Adverse Events of Anti-HIV Drugs study and discusses the impact of different methodological approaches on estimates of the prevalence of metabolic syndrome over time. Methods: We described the prevalence of the metabolic syndrome in patients under follow-up at the end of six calendar periods from 2000 to 2007. The definition that was used for the metabolic syndrome was modified to take account of the use of lipid-lowering and antihypertensive medication, measurement variability and missing values, and assessed the impact of these modifications on the estimated prevalence. Results: For all definitions considered, there was an increasing prevalence of the metabolic syndrome over time, although the prevalence estimates themselves varied widely. Using our primary definition, we found an increase in prevalence from 19.4% in 2000/2001 to 41.6% in 2006/2007. Modification of the definition to incorporate antihypertensive and lipid-lowering medication had relatively little impact on the prevalence estimates, as did modification to allow for missing data. In contrast, modification to allow the metabolic syndrome to be reversible and to allow for measurement variability lowered prevalence estimates substantially. Discussion: The prevalence of the metabolic syndrome in cohort studies is largely based on the use of nonstandardized measurements as they are captured in daily clinical care. As a result, bias is easily introduced, particularly when measurements are both highly variable and may be missing. We suggest that the prevalence of the metabolic syndrome in cohort studies should be based on two consecutive measurements of the laboratory components in the syndrome definition.

Original language	English
Journal	AIDS
Volume	24
Issue number	3
Pages (from-to)	427-35
Number of pages	9
ISSN	0269-9370
DOIs	https://doi.org/10.1097/qad.0b013e328334344e
Publication status	Published - 28 Jan 2010

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Worm, S. H. W., Friis-Møller, N., Bruyand, M., D'Arminio Monforte, A., Rickenbach, M., Reiss, P., El-Sadr, W., Phillips, A., Lundgren, J. D., Sabin, C., & D:A:D Study Group (2010). High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome. AIDS, 24(3), 427-35. https://doi.org/10.1097/qad.0b013e328334344e

Worm, SHW, Friis-Møller, N, Bruyand, M, D'Arminio Monforte, A, Rickenbach, M, Reiss, P, El-Sadr, W, Phillips, A, Lundgren, JD, Sabin, C & D:A:D Study Group 2010, 'High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome', AIDS, vol. 24, no. 3, pp. 427-35. https://doi.org/10.1097/qad.0b013e328334344e

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abstract = "Introduction: This study describes the characteristics of the metabolic syndrome in HIV-positive patients in the Data Collection on Adverse Events of Anti-HIV Drugs study and discusses the impact of different methodological approaches on estimates of the prevalence of metabolic syndrome over time. Methods: We described the prevalence of the metabolic syndrome in patients under follow-up at the end of six calendar periods from 2000 to 2007. The definition that was used for the metabolic syndrome was modified to take account of the use of lipid-lowering and antihypertensive medication, measurement variability and missing values, and assessed the impact of these modifications on the estimated prevalence. Results: For all definitions considered, there was an increasing prevalence of the metabolic syndrome over time, although the prevalence estimates themselves varied widely. Using our primary definition, we found an increase in prevalence from 19.4% in 2000/2001 to 41.6% in 2006/2007. Modification of the definition to incorporate antihypertensive and lipid-lowering medication had relatively little impact on the prevalence estimates, as did modification to allow for missing data. In contrast, modification to allow the metabolic syndrome to be reversible and to allow for measurement variability lowered prevalence estimates substantially. Discussion: The prevalence of the metabolic syndrome in cohort studies is largely based on the use of nonstandardized measurements as they are captured in daily clinical care. As a result, bias is easily introduced, particularly when measurements are both highly variable and may be missing. We suggest that the prevalence of the metabolic syndrome in cohort studies should be based on two consecutive measurements of the laboratory components in the syndrome definition.",

author = "Worm, {Signe H.Westring} and Nina Friis-M{\o}ller and Mathias Bruyand and {D'Arminio Monforte}, Antonella and Martin Rickenbach and Peter Reiss and Wafaa El-Sadr and Andrew Phillips and Lundgren, {Jens Dilling} and Caroline Sabin and Nina Friis-M{\o}ller",

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AU - Worm, Signe H.Westring

AU - Friis-Møller, Nina

AU - Bruyand, Mathias

AU - D'Arminio Monforte, Antonella

AU - Rickenbach, Martin

AU - Reiss, Peter

AU - El-Sadr, Wafaa

AU - Phillips, Andrew

AU - Lundgren, Jens Dilling

AU - Sabin, Caroline

AU - D:A:D Study Group

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N2 - Introduction: This study describes the characteristics of the metabolic syndrome in HIV-positive patients in the Data Collection on Adverse Events of Anti-HIV Drugs study and discusses the impact of different methodological approaches on estimates of the prevalence of metabolic syndrome over time. Methods: We described the prevalence of the metabolic syndrome in patients under follow-up at the end of six calendar periods from 2000 to 2007. The definition that was used for the metabolic syndrome was modified to take account of the use of lipid-lowering and antihypertensive medication, measurement variability and missing values, and assessed the impact of these modifications on the estimated prevalence. Results: For all definitions considered, there was an increasing prevalence of the metabolic syndrome over time, although the prevalence estimates themselves varied widely. Using our primary definition, we found an increase in prevalence from 19.4% in 2000/2001 to 41.6% in 2006/2007. Modification of the definition to incorporate antihypertensive and lipid-lowering medication had relatively little impact on the prevalence estimates, as did modification to allow for missing data. In contrast, modification to allow the metabolic syndrome to be reversible and to allow for measurement variability lowered prevalence estimates substantially. Discussion: The prevalence of the metabolic syndrome in cohort studies is largely based on the use of nonstandardized measurements as they are captured in daily clinical care. As a result, bias is easily introduced, particularly when measurements are both highly variable and may be missing. We suggest that the prevalence of the metabolic syndrome in cohort studies should be based on two consecutive measurements of the laboratory components in the syndrome definition.

AB - Introduction: This study describes the characteristics of the metabolic syndrome in HIV-positive patients in the Data Collection on Adverse Events of Anti-HIV Drugs study and discusses the impact of different methodological approaches on estimates of the prevalence of metabolic syndrome over time. Methods: We described the prevalence of the metabolic syndrome in patients under follow-up at the end of six calendar periods from 2000 to 2007. The definition that was used for the metabolic syndrome was modified to take account of the use of lipid-lowering and antihypertensive medication, measurement variability and missing values, and assessed the impact of these modifications on the estimated prevalence. Results: For all definitions considered, there was an increasing prevalence of the metabolic syndrome over time, although the prevalence estimates themselves varied widely. Using our primary definition, we found an increase in prevalence from 19.4% in 2000/2001 to 41.6% in 2006/2007. Modification of the definition to incorporate antihypertensive and lipid-lowering medication had relatively little impact on the prevalence estimates, as did modification to allow for missing data. In contrast, modification to allow the metabolic syndrome to be reversible and to allow for measurement variability lowered prevalence estimates substantially. Discussion: The prevalence of the metabolic syndrome in cohort studies is largely based on the use of nonstandardized measurements as they are captured in daily clinical care. As a result, bias is easily introduced, particularly when measurements are both highly variable and may be missing. We suggest that the prevalence of the metabolic syndrome in cohort studies should be based on two consecutive measurements of the laboratory components in the syndrome definition.

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JO - AIDS, Supplement

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High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome

Abstract

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