Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemic
IntroductionThe aim of this study was to analyze the impact of COVID-19 pandemic restrictions on the prevalence and incidence of metabolic syndrome (MS), and to identify predictors of new MS cases in people living with HIV (PLWH).MethodsThis cohort study included PLWH followed at the IRCCS San Raffa...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-09-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1220631/full |
| _version_ | 1827814804526465024 |
|---|---|
| author | Rebecka Papaioannu Borjesson Laura Galli Camilla Muccini Andrea Poli Tommaso Clemente Martina Bottanelli Nicola Gianotti Silvia Nozza Silvia Nozza Antonella Castagna Antonella Castagna Vincenzo Spagnuolo |
| author_facet | Rebecka Papaioannu Borjesson Laura Galli Camilla Muccini Andrea Poli Tommaso Clemente Martina Bottanelli Nicola Gianotti Silvia Nozza Silvia Nozza Antonella Castagna Antonella Castagna Vincenzo Spagnuolo |
| author_sort | Rebecka Papaioannu Borjesson |
| collection | DOAJ |
| description | IntroductionThe aim of this study was to analyze the impact of COVID-19 pandemic restrictions on the prevalence and incidence of metabolic syndrome (MS), and to identify predictors of new MS cases in people living with HIV (PLWH).MethodsThis cohort study included PLWH followed at the IRCCS San Raffaele, Milan, Italy, with at least one body mass index (BMI) determination during the pre-pandemic period (1 December 2018 to 29 February 2020) and the pandemic period (1 March 2020 to 31 May 2021). MS diagnosis was based on NCEP ATP III 2005 criteria. Univariable Poisson regression model was used to compare MS incidence rates. Univariable mixed linear models estimated the crude mean change in metabolic parameters during each time period. Multivariable Cox proportional hazards model was used to assess risk factors for MS.ResultsThis study included 1,564 PLWH, of whom 460 and 1,104 were with and without a diagnosis of MS, respectively, at the beginning of the pre-pandemic period, with an overall prevalence of MS of 29.4%. During the pre-pandemic period, 528/1,564 PLWH had MS, with a prevalence of 33.8% (95%CI = 31.5%–36.1%), while during the pandemic period, the number of PLWH with a diagnosis of MS increased to 628/1,564, with a prevalence of 40.2% (95%CI 37.8%–42.6%; McNemar’s test: p < 0.0001). Similarly, the MS incidence rate increased from 13.7/100 person-years of follow-up (PYFU; 95%CI = 11.7–16.0) in the pre-pandemic period to 18.5/100 PYFU (95%CI = 16.2–21.1) in the pandemic period (p = 0.004), with 201 subjects developing MS during the pandemic period. In addition, we observed a significant increase in the crude mean change during the pandemic period compared with the pre-pandemic period for: total cholesterol, LDL cholesterol, plasma glucose, blood pressure, and atherosclerotic cardiovascular disease (ASCVD) risk score. Finally, after adjustment for HIV risk factors, HBV, HCV, ART duration, duration of virologic suppression and use of INSTIs, age [adjusted hazard ratio (AHR) per 3 years older = 1.12 (95%CI = 1.08–1.17)], sex [AHR female vs. male = 0.62 (95%CI = 0.44–0.87)] and CD4+ cell count [AHR per 100 cells/μL higher = 1.05 (95%CI = 1.01–1.09)] were associated with the risk of MS.ConclusionThe COVID-19 pandemic affected the metabolic profile of PLWH and increased the prevalence and incidence of MS. |
| first_indexed | 2024-03-11T23:51:07Z |
| format | Article |
| id | doaj.art-572835c26b8e404b81a73412b1a49bc9 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-11T23:51:07Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-572835c26b8e404b81a73412b1a49bc92023-09-19T07:27:47ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-09-011010.3389/fmed.2023.12206311220631Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemicRebecka Papaioannu Borjesson0Laura Galli1Camilla Muccini2Andrea Poli3Tommaso Clemente4Martina Bottanelli5Nicola Gianotti6Silvia Nozza7Silvia Nozza8Antonella Castagna9Antonella Castagna10Vincenzo Spagnuolo11School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, ItalyInfectious Diseases Unit, San Raffaele Scientific Institute, Milan, ItalyInfectious Diseases Unit, San Raffaele Scientific Institute, Milan, ItalyInfectious Diseases Unit, San Raffaele Scientific Institute, Milan, ItalySchool of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, ItalySchool of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, ItalyInfectious Diseases Unit, San Raffaele Scientific Institute, Milan, ItalySchool of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, ItalyInfectious Diseases Unit, San Raffaele Scientific Institute, Milan, ItalySchool of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, ItalyInfectious Diseases Unit, San Raffaele Scientific Institute, Milan, ItalyInfectious Diseases Unit, San Raffaele Scientific Institute, Milan, ItalyIntroductionThe aim of this study was to analyze the impact of COVID-19 pandemic restrictions on the prevalence and incidence of metabolic syndrome (MS), and to identify predictors of new MS cases in people living with HIV (PLWH).MethodsThis cohort study included PLWH followed at the IRCCS San Raffaele, Milan, Italy, with at least one body mass index (BMI) determination during the pre-pandemic period (1 December 2018 to 29 February 2020) and the pandemic period (1 March 2020 to 31 May 2021). MS diagnosis was based on NCEP ATP III 2005 criteria. Univariable Poisson regression model was used to compare MS incidence rates. Univariable mixed linear models estimated the crude mean change in metabolic parameters during each time period. Multivariable Cox proportional hazards model was used to assess risk factors for MS.ResultsThis study included 1,564 PLWH, of whom 460 and 1,104 were with and without a diagnosis of MS, respectively, at the beginning of the pre-pandemic period, with an overall prevalence of MS of 29.4%. During the pre-pandemic period, 528/1,564 PLWH had MS, with a prevalence of 33.8% (95%CI = 31.5%–36.1%), while during the pandemic period, the number of PLWH with a diagnosis of MS increased to 628/1,564, with a prevalence of 40.2% (95%CI 37.8%–42.6%; McNemar’s test: p < 0.0001). Similarly, the MS incidence rate increased from 13.7/100 person-years of follow-up (PYFU; 95%CI = 11.7–16.0) in the pre-pandemic period to 18.5/100 PYFU (95%CI = 16.2–21.1) in the pandemic period (p = 0.004), with 201 subjects developing MS during the pandemic period. In addition, we observed a significant increase in the crude mean change during the pandemic period compared with the pre-pandemic period for: total cholesterol, LDL cholesterol, plasma glucose, blood pressure, and atherosclerotic cardiovascular disease (ASCVD) risk score. Finally, after adjustment for HIV risk factors, HBV, HCV, ART duration, duration of virologic suppression and use of INSTIs, age [adjusted hazard ratio (AHR) per 3 years older = 1.12 (95%CI = 1.08–1.17)], sex [AHR female vs. male = 0.62 (95%CI = 0.44–0.87)] and CD4+ cell count [AHR per 100 cells/μL higher = 1.05 (95%CI = 1.01–1.09)] were associated with the risk of MS.ConclusionThe COVID-19 pandemic affected the metabolic profile of PLWH and increased the prevalence and incidence of MS.https://www.frontiersin.org/articles/10.3389/fmed.2023.1220631/fullmetabolic syndromeHIVdiabetesdyslipidemiaantiretroviral therapyCOVID-19 |
| spellingShingle | Rebecka Papaioannu Borjesson Laura Galli Camilla Muccini Andrea Poli Tommaso Clemente Martina Bottanelli Nicola Gianotti Silvia Nozza Silvia Nozza Antonella Castagna Antonella Castagna Vincenzo Spagnuolo Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemic Frontiers in Medicine metabolic syndrome HIV diabetes dyslipidemia antiretroviral therapy COVID-19 |
| title | Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemic |
| title_full | Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemic |
| title_fullStr | Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemic |
| title_full_unstemmed | Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemic |
| title_short | Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemic |
| title_sort | increasing incidence and prevalence of metabolic syndrome in people living with hiv during the covid 19 pandemic |
| topic | metabolic syndrome HIV diabetes dyslipidemia antiretroviral therapy COVID-19 |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1220631/full |
| work_keys_str_mv | AT rebeckapapaioannuborjesson increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT lauragalli increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT camillamuccini increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT andreapoli increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT tommasoclemente increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT martinabottanelli increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT nicolagianotti increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT silvianozza increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT silvianozza increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT antonellacastagna increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT antonellacastagna increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic AT vincenzospagnuolo increasingincidenceandprevalenceofmetabolicsyndromeinpeoplelivingwithhivduringthecovid19pandemic |