Metabolic syndrome and cardiovascular risk in HIV-infected patients with lipodystrophy

Int J Immunopathol Pharmacol. 2007 Jul-Sep;20(3):519-27. doi: 10.1177/039463200702000310.


In this cross-sectional study, we evaluate potential predictors of Metabolic Syndrome (MS) in a group of 54 Caucasian chronically HIV-infected patients with lipodystrophy. According to ATP-III criteria, 22 patients were affected by MS and 32 were not. The mean age of the sample was 41.2+/-8.6 years, and most patients were males (74.1%); the two groups were homogeneous for gender, age, viro-immunologic status and the duration of antiviral therapy. The independent association between MS and several factors including demographic characteristics, type of highly-active antiviral therapy (HAART), viro-immunologic response, common cardiovascular risk factors (including Framingham scores), and selected cytokines (IFN-gamma, TNF-alpha, IL-2, IL-4, IL-6, IL-10 and IL-18), was investigated using stepwise forward logistic regression. At multivariate analysis, the only independent predictors of the metabolic syndrome were triglycerides and IL-18. A 10 mg/dL increase in triglycerides corresponds to an adjusted risk ratio for MS of 1.11 (95 percent IC: 1.04-1.19); and patients in the top tertile of IL-18 (those with IL-18 >/= 530 pg/L) had more than three times the likelihood of MS, as compared to the bottom and medium tertiles of IL-18 (patients with IL-18< 530 pg/L). This relationship was not attenuated by the inclusion of any other variable in the multivariate model. However, the association between metabolic syndrome and IL-18 is no longer significant when IL-18 is treated as a continuous variable (trend p = 0.087). Our results on HIV patients with lipodystrophy confirm previous findings on a strong independent association between IL-18 and MS in the general population. Further research is needed to clarify the mechanism of this association and its role in the development of cardiovascular disease in HIV patients.

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / etiology*
  • Cross-Sectional Studies
  • Cytokines / blood
  • Cytokines / immunology
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / immunology
  • HIV Infections / metabolism
  • HIV-Associated Lipodystrophy Syndrome / etiology
  • HIV-Associated Lipodystrophy Syndrome / immunology
  • HIV-Associated Lipodystrophy Syndrome / metabolism
  • Humans
  • Lipid Metabolism
  • Male
  • Metabolic Syndrome / etiology*
  • Metabolic Syndrome / immunology
  • Metabolic Syndrome / metabolism
  • Prognosis
  • Risk
  • Triglycerides / blood
  • Viral Load


  • Anti-HIV Agents
  • Cytokines
  • Triglycerides