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Higher Risk of Abdominal Obesity, Elevated Low-Density Lipoprotein Cholesterol, and Hypertriglyceridemia, but not of Hypertension, in People Living With Human Immunodeficiency Virus (HIV): Results From the Copenhagen Comorbidity in HIV Infection Study

Gelpi, M; Afzal, S; Lundgren, J; Ronit, A; Roen, A; Mocroft, A; Gerstoft, J; ... Nielsen, SD; + view all (2018) Higher Risk of Abdominal Obesity, Elevated Low-Density Lipoprotein Cholesterol, and Hypertriglyceridemia, but not of Hypertension, in People Living With Human Immunodeficiency Virus (HIV): Results From the Copenhagen Comorbidity in HIV Infection Study. Clinical Infectious Diseases , 67 (4) pp. 579-586. 10.1093/cid/ciy146. Green open access

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Abstract

Background: People living with HIV (PLWH) have lower life expectancy than uninfected individuals, partly explained by excess risk of cardiovascular diseases (CVD) and CVD risk factors. We investigated the association between HIV infection and abdominal obesity, elevated LDL cholesterol (LDL-C), hypertriglyceridemia and hypertension, in a large cohort of predominantly well-treated PLWH and matched controls. Methods: 1,099 PLWH from the Copenhagen Co-morbidity in HIV infection (COCOMO) study and 12,161 age and sex-matched uninfected controls from the Copenhagen General Population Study were included and underwent blood pressure, waist-, hip-, weight-, and height-measurements. Non-fasting blood samples were obtained from all participants. We assessed whether HIV was independently associated with abdominal obesity, elevated LDL-C, hypertriglyceridemia and hypertension using logistic regression models adjusted for known risk factors. Results: HIV infection was associated with higher risk of abdominal obesity (adjusted odds ratio (aOR): 1.92[1.60-2.30]) for a given BMI, elevated LDL-C (aOR: 1.32[1.09-1.59]), hypertriglyceridemia (aOR 1.76[1.49-2.08]), and lower risk of hypertension (aOR: 0.63[0.54 - 0.74]). The excess odds of abdominal obesity in PLWH was stronger with older age (p-interaction 0.001). Abdominal obesity was associated with elevated LDL-C (aOR: 1.44[1.23-1.69]), hypertension (aOR: 1.32[1.16-1.49]), and hypertriglyceridemia (aOR: 2.12[1.86-2.41]). Low CD4 nadir and duration of HIV infection were associated with the presence of abdominal obesity (aOR: 1.71[1.12-2.62] and aOR: 1.37/5-years[1.11-1.70]). Conclusions: Abdominal obesity was associated with proaterogenic metabolic factors including elevated LDL-C, hypertension and hypertriglyceridemia and remains a distinct HIV-related phenotype particularly among older PLWH. Effective interventions to reduce the apparent detrimental impact on cardiovascular risk from this phenotype are needed.

Type: Article
Title: Higher Risk of Abdominal Obesity, Elevated Low-Density Lipoprotein Cholesterol, and Hypertriglyceridemia, but not of Hypertension, in People Living With Human Immunodeficiency Virus (HIV): Results From the Copenhagen Comorbidity in HIV Infection Study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/cid/ciy146
Publisher version: https://doi.org/10.1093/cid/ciy146
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: HIV-infection, abdominal obesity, elevated LDL cholesterol, hypertension, hypertriglyceridemia
UCL classification: UCL
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 Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10045009
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