Metabolic syndrome in HIV-associated lipodystrophy

Objectives The aim of our study was to describe the interaction and the overlapping features of lipodystrophy and metabolic syndrome in HIV-infected patients and verify the role of HIV viremia (viral load) on the development of metabolic abnormalities related to these conditions. Methods Cross sectional study of consecutive HIV-patients attending the Metabolic Clinic (MC) of Modena University (Italy) using NCEP-ATP III MS criteria. Results 361 patients were evaluated for anthropometry, DEXA, Triglycerides (TG), HDL-Cholesterol (HDL), Glucose (Glu), Insulin, Waist circumference (WC), Blood pressure (BP). Patients with MS (25.4% of our sample) differed significantly from patients without MS for the following anthropometric and metabolic variables: BMI (mean 24.9 [SD 3.7] vs 22.6 [3] ; p<0.0001), WHR ( 0.99 [0.07] vs 0.94 [0.07]; p< 0.0001), WC (91.34 [10.3] vs 83.86 [8.8]; p<0.0001), trunk fat (7021.05 [3765.06] vs 5736.00 [2845.23]; p<0.001), HOMA-IR (6.9[8.86] vs 4.01[6.4]; p<0.001), HDL (34.55[10.14] vs 44.25[14.15]; p<0.0001) and TG (283.3 [217.48] vs 202.38 [196.85]; p<0.0001). We elaborated a statistical interaction that showed HIV has an impact on HDL and TG values while ART seems to affect TG more than HDL. Conclusion In conclusion we described the overlapping features of lipodystrophy and metabolic syndrome in HIVinfected patients. Insulin resistance appears to be the most relevant interaction between common metabolic and morphologic variables. Both HIV VL and HAART appear to be associated to these clinical syndromes.