Original Research

The metabolic syndrome and renal function in an African cohort infected with human immunodeficiency virus

Edith Phalane, Carla M.T. Fourie, Aletta E. Schutte
Southern African Journal of HIV Medicine | Vol 19, No 1 | a813 | DOI: https://doi.org/10.4102/sajhivmed.v19i1.813 | © 2018 Edith Phalane, Carla M.T. Fourie, Aletta E. Schutte | This work is licensed under CC Attribution 4.0
Submitted: 01 November 2017 | Published: 20 September 2018

About the author(s)

Edith Phalane, Hypertension in Africa Research Team, North-West University, South Africa
Carla M.T. Fourie, Hypertension in Africa Research Team, North-West University, South Africa; and, Medical Research Council Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, South Africa
Aletta E. Schutte, Hypertension in Africa Research Team, North-West University, South Africa; and, Medical Research Council Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, South Africa


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Abstract

Introduction: The human immunodeficiency virus (HIV) is often accompanied by renal dysfunction. It is expected that metabolic syndrome (MetS) may exacerbate renal impairment.

Objective: We therefore determined the prevalence of MetS and the association thereof with renal function in a South African cohort infected with HIV.

Methods: We matched 114 HIV-infected (77.3% on antiretroviral therapy [ART] and 22.7% ART-naïve) and 114 HIV-uninfected individuals according to age, sex and locality. We examined cardiovascular, anthropometric and metabolic measurements and determined the MetS. Renal function was assessed using standardised procedures.

Results: The prevalence of MetS was lower in the HIV-infected individuals as compared to the uninfected individuals (28% vs. 44%, p = 0.013). The HIV-infected group presented with a lower body mass index (BMI) and waist circumference (WC) (all p < 0.001), as well as blood pressure (BP) (p ≤ 0.0021). The results were confirmed when comparing the HIV-infected group using ART (N = 85) and the HIV-uninfected group. When comparing the HIV-infected individuals with MetS to the HIV-uninfected individuals with MetS, no differences in BP were seen. With regard to renal function, the HIV-infected individuals with MetS (n = 32) had 43% higher urinary albumin-creatinine ratio (uACR) compared to the HIV-uninfected individuals with MetS, after adjusting for age, sex and WC (p = 0.032). None of the other renal function markers differed after adjustments for WC or BMI.

Conclusion: The HIV-infected Africans with MetS had almost twofold higher uACR, despite the low prevalence of MetS, compared to their uninfected counterparts. The combination of HIV and MetS seemed to increase the risk for renal impairment.


Keywords

cardio-metabolic diseases; HIV

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