Endocrine Abstracts

Introduction: The prevalence of metabolic syndrome (MetS) is increasing in patients with HIV infection on highly active antiretroviral therapy (HAART). Additionally, HCV coinfection is common among HIV patients in our area. It is widely known MetS impacts on the liver in different ways but relationship between both MetS and liver function is few studied in HIV/HVC co-infected population.

Methods/design: Cross-sectional study including 35 HIV/HVC co-infected patients. Patients with significant ascites were excluded for analysis. All patients were screened for visceral obesity, dyslipidemia, hyperglycemia, and hypertension. Abdominal circumference was also measured. NCEP-ATP III criteria were used to define MetS and Model for End-Stage Liver Disease (MELD) score was calculated for every patient. Patients were divided into two groups according to median MELD score. Continuous variables are presented as mean and standard deviation or as median and interquartile range based on data distribution. Categorical variables are presented as frequencies.

Results: Prevalence of MetS was higher among patients with higher MELD score (100% vs 27.6%; P=0.002). When every individual component of MetS was analyzed, high abdominal circumference was more prevalent among patients with higher MELD score (54.5% vs 14.3%; P=0.003) but no other showed significant difference between groups. Patients with higher MELD score also had lower levels of HDLc (38 (33–45) vs 46 (39–58) mg/dl; P=0.032). Among patients with higher MELD score, no significant differences were observed according to LDLc (89.9±25.8 vs 107.2±37.2 mg/dl; P=0.08) tryglicerides levels (114 (83.2–198.2) vs 129 (93–185) mg/dl; P=0.37), systolic blood pressure (121 (113.2–130) vs 120 (107–130) mm Hg; P=0.20) or dyastolic blood pressure (80 (74–82) vs 77 (70–80) mm Hg; P=0.08).

Conclusions: A worse liver function is linked to development of MetS in HIV/HCV co-infected patients on HAART and therefore, related to higher cardiovascular risk. Abdominal circumference and lipid profile are major determinants for the higher rate of MetS observed in these patients. Due to the cross-sectional nature of our observation, further follow-up studies are needed to delucidate cause-effect.