Prevalence and predictors of metabolic syndrome among HIV-infected and HIV-uninfected women in the Women's Interagency HIV Study

Objectives: To assess the prevalence of metabolic syndrome (MetSynd) among participants of the Women's Interagency HIV Study and to describe the association of MetSynd with HIV infection, antiretroviral therapies, and sociodemographic factors. Methods: Prevalence of MetSynd, defined by updated Adult Treatment Panel III guidelines, was assessed among 2393 (1725 seropositive and 668 seronegative) participants from the Women's Interagency HIV Study seen between October 2000 and October 2004. Results: HIV-1 infection was independently associated with MetSynd [33% vs 22%, P < 0.0001 in HIV-seropositive compared with HIV-seronegative women; adjusted odds ratio (OR) 1.79 (95% confidence interval 1.48, 2.16)]. HIV-infected women had higher mean triglyceride (154 vs 10 1 mg/dL, P < 0.0001), and lower mean high-density lipoprotein cholesterol levels (46 vs 55 mg/dL, P < 0.0001). Most notable factors associated with higher prevalence of MetSynd among HIV-infected women included older age (OR = 1.38 per 5 year increase, P < 0.0001); higher body mass index; current smoking; HIV-1 RNA (OR = 1.36, P = 0.019, for >50,000 vs <80 copies/mL); and use of stavudine (OR 1.28, P = 0.009). Nevirapine use was protective (OR = 0.75, P = 0.016). There was no significant association of MetSynd with ritonavir-boosted protease inhibitors (OR = 1.15, P = 0.134). Conclusions: MetSynd is more prevalent in HIV-seropositive than HIV-seronegative women. This increased prevalence was due to dyslipidemias rather than higher blood pressure, glucose, or waist circumference.