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

Worm, SW; Friis-Moller, N; Bruyand, M; Monforte, AD; Rickenbach, M; Reiss, P; El-Sadr, W; ... DAD Study Grp, ; + view all (2010) High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome. AIDS , 24 (3) 427 - 435. 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 anti hypertensive 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 200012001 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. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

Type: Article
Title: High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome
DOI: 10.1097/QAD.0b013e328334344e
Keywords: epidemiology, HIV, metabolic syndrome, observational study, COMBINATION ANTIRETROVIRAL THERAPY, CARDIOVASCULAR-DISEASE, LIPID PROFILES, ASSOCIATION, POPULATION, COHORT, GUIDELINES, MANAGEMENT, COMPONENTS, STATEMENT
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: http://discovery.ucl.ac.uk/id/eprint/110191
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