Presence of the Metabolic Syndrome Is Not a Better Predictor of Cardiovascular Disease Than the Sum of Its Components in HIV-lnfected Individuals : Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) study
Identifieur interne : 008151 ( Main/Exploration ); précédent : 008150; suivant : 008152Presence of the Metabolic Syndrome Is Not a Better Predictor of Cardiovascular Disease Than the Sum of Its Components in HIV-lnfected Individuals : Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) study
Auteurs : Signe W. Worm [Danemark] ; Caroline A. Sabin [Royaume-Uni] ; Peter Reiss [Pays-Bas] ; Wafaa El-Sadr [États-Unis] ; Antonella D'Arminio Monforte [Italie] ; Christian Pradier [France] ; Rodolphe Thiebaut [France] ; Matthew Law [Australie] ; Martin Rickenbach [Suisse] ; Stephane De Wit [Belgique] ; Jens D. Lundgren [Danemark] ; Nina Frits-M Ller [Danemark]Source :
- Diabetes care [ 0149-5992 ] ; 2009.
Descripteurs français
- Pascal (Inist)
- Syndrome métabolique, Prédiction, Facteur prédictif, Pathologie de l'appareil circulatoire, Virus immunodéficience humaine, SIDA, Homme, Collecte donnée, Toxicité, Complication, Pharmacovigilance, Médicament, Effet secondaire, Antiviral, Association médicamenteuse, Etude cohorte, Analyse statistique, Maladie cardiovasculaire.
- Wicri :
- topic : Homme, Médicament.
English descriptors
- KwdEn :
Abstract
OBJECTIVE - It is much debated whether the metabolic syndrome contributes additional information over and above that provided by the individual components of the syndrome alone. Among HIV-infected individuals, we investigated whether any particular combinations of the components included in the definition of the metabolic syndrome are associated with a higher risk of cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS- We followed 33,347 HIV-infected individuals in a prospective observational study. The effect of combinations of components of the metabolic syndrome (low HDL cholesterol, high triglycerides, high BMI, hypertension, and diabetes) on the risk of CVD was assessed by Poisson regression incorporating interactions between each component pair and adjusting for age, sex, family history of CVD, smoking status, calendar year, and exposure to antiretroviral therapy. We reduced the risk of type 1 errors by randomly splitting the data set for training (70% of sample) and validation (remaining 30%). RESULTS- In the training data set, 671 patients experienced a CVD event over 110,652 person-years. Unadjusted, the presence of metabolic syndrome at study enrollment (≥3 of the factors) was associated with a 2.89 higher risk of CVD (95% CI 2.34-3.59; P = 0.0001) compared with individuals without the metabolic syndrome. After adjustment for the individual components, the metabolic syndrome as an entity no longer predicted the risk of CVD (adjusted relative risk 0.85; 95% CI 0.61-1.17; P = 0.32) No significant positive interactions were found among the components of the metabolic syndrome. CONCLUSIONS - The presence of the metabolic syndrome in HIV-infected individuals did not appear to increase the CVD risk over and above that conferred by the components of the syndrome separately.
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Affiliations:
- Australie, Belgique, Danemark, France, Italie, Pays-Bas, Royaume-Uni, Suisse, États-Unis
- Angleterre, Aquitaine, Canton de Vaud, Grand Londres, Hollande-Septentrionale, Hovedstaden, Lombardie, Nouvelle-Aquitaine, Nouvelle-Galles du Sud, Provence-Alpes-Côte d'Azur, Région de Bruxelles-Capitale, État de New York
- Amsterdam, Bordeaux, Bruxelles, Copenhague, Lausanne, Londres, Milan, Nice, Sydney
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Worm</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Copenhagen HIV Programme, University of Copenhagen</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>1 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Danemark</country><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A." last="Sabin">Caroline A. Sabin</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Royal Free and University College</s1><s2>London</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Academic Medical Center</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>3 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="El Sadr, Wafaa" sort="El Sadr, Wafaa" uniqKey="El Sadr W" first="Wafaa" last="El-Sadr">Wafaa El-Sadr</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Harlem Hospital Center, Division of Infectious Diseases</s1><s2>New York, New York</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="D Arminio Monforte, Antonella" sort="D Arminio Monforte, Antonella" uniqKey="D Arminio Monforte A" first="Antonella" last="D'Arminio Monforte">Antonella D'Arminio Monforte</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>University of Milan</s1><s2>Milan</s2><s3>ITA</s3><sZ>5 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Pradier, Christian" sort="Pradier, Christian" uniqKey="Pradier C" first="Christian" last="Pradier">Christian Pradier</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Hopital Archet 1</s1><s2>Nice</s2><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Nice</settlement></placeName></affiliation></author><author><name sortKey="Thiebaut, Rodolphe" sort="Thiebaut, Rodolphe" uniqKey="Thiebaut R" first="Rodolphe" last="Thiebaut">Rodolphe Thiebaut</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Université Victor Segalen</s1><s2>Bordeaux</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>National Centre in HIV Epidemiology and Clinical Research</s1><s2>Sydney</s2><s3>AUS</s3><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Rickenbach, Martin" sort="Rickenbach, Martin" uniqKey="Rickenbach M" first="Martin" last="Rickenbach">Martin Rickenbach</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>University Hospital</s1><s2>Lausanne</s2><s3>CHE</s3><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stephane" last="De Wit">Stephane De Wit</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>University Hospital St. Pierre</s1><s2>Brussels</s2><s3>BEL</s3><sZ>10 aut.</sZ></inist:fA14><country>Belgique</country><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Copenhagen HIV Programme, University of Copenhagen</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>1 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Danemark</country><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Frits M Ller, Nina" sort="Frits M Ller, Nina" uniqKey="Frits M Ller N" first="Nina" last="Frits-M Ller">Nina Frits-M Ller</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Copenhagen HIV Programme, University of Copenhagen</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>1 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Danemark</country><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Diabetes care</title><title level="j" type="abbreviated">Diabetes care</title><idno type="ISSN">0149-5992</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Diabetes care</title><title level="j" type="abbreviated">Diabetes care</title><idno type="ISSN">0149-5992</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term><term>Antiviral</term><term>Cardiovascular disease</term><term>Cohort study</term><term>Complication</term><term>Data gathering</term><term>Drug</term><term>Drug combination</term><term>Human</term><term>Human immunodeficiency virus</term><term>Metabolic syndrome</term><term>Pharmacovigilance</term><term>Prediction</term><term>Predictive factor</term><term>Secondary effect</term><term>Statistical analysis</term><term>Toxicity</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Syndrome métabolique</term><term>Prédiction</term><term>Facteur prédictif</term><term>Pathologie de l'appareil circulatoire</term><term>Virus immunodéficience humaine</term><term>SIDA</term><term>Homme</term><term>Collecte donnée</term><term>Toxicité</term><term>Complication</term><term>Pharmacovigilance</term><term>Médicament</term><term>Effet secondaire</term><term>Antiviral</term><term>Association médicamenteuse</term><term>Etude cohorte</term><term>Analyse statistique</term><term>Maladie cardiovasculaire</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Médicament</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">OBJECTIVE - It is much debated whether the metabolic syndrome contributes additional information over and above that provided by the individual components of the syndrome alone. Among HIV-infected individuals, we investigated whether any particular combinations of the components included in the definition of the metabolic syndrome are associated with a higher risk of cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS- We followed 33,347 HIV-infected individuals in a prospective observational study. The effect of combinations of components of the metabolic syndrome (low HDL cholesterol, high triglycerides, high BMI, hypertension, and diabetes) on the risk of CVD was assessed by Poisson regression incorporating interactions between each component pair and adjusting for age, sex, family history of CVD, smoking status, calendar year, and exposure to antiretroviral therapy. We reduced the risk of type 1 errors by randomly splitting the data set for training (70% of sample) and validation (remaining 30%). RESULTS- In the training data set, 671 patients experienced a CVD event over 110,652 person-years. Unadjusted, the presence of metabolic syndrome at study enrollment (≥3 of the factors) was associated with a 2.89 higher risk of CVD (95% CI 2.34-3.59; P = 0.0001) compared with individuals without the metabolic syndrome. After adjustment for the individual components, the metabolic syndrome as an entity no longer predicted the risk of CVD (adjusted relative risk 0.85; 95% CI 0.61-1.17; P = 0.32) No significant positive interactions were found among the components of the metabolic syndrome. CONCLUSIONS - The presence of the metabolic syndrome in HIV-infected individuals did not appear to increase the CVD risk over and above that conferred by the components of the syndrome separately.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Belgique</li><li>Danemark</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Aquitaine</li><li>Canton de Vaud</li><li>Grand Londres</li><li>Hollande-Septentrionale</li><li>Hovedstaden</li><li>Lombardie</li><li>Nouvelle-Aquitaine</li><li>Nouvelle-Galles du Sud</li><li>Provence-Alpes-Côte d'Azur</li><li>Région de Bruxelles-Capitale</li><li>État de New York</li></region><settlement><li>Amsterdam</li><li>Bordeaux</li><li>Bruxelles</li><li>Copenhague</li><li>Lausanne</li><li>Londres</li><li>Milan</li><li>Nice</li><li>Sydney</li></settlement></list><tree><country name="Danemark"><region name="Hovedstaden"><name sortKey="Worm, Signe W" sort="Worm, Signe W" uniqKey="Worm S" first="Signe W." last="Worm">Signe W. Worm</name></region><name sortKey="Frits M Ller, Nina" sort="Frits M Ller, Nina" uniqKey="Frits M Ller N" first="Nina" last="Frits-M Ller">Nina Frits-M Ller</name><name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A." last="Sabin">Caroline A. Sabin</name></region></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name></region></country><country name="États-Unis"><region name="État de New York"><name sortKey="El Sadr, Wafaa" sort="El Sadr, Wafaa" uniqKey="El Sadr W" first="Wafaa" last="El-Sadr">Wafaa El-Sadr</name></region></country><country name="Italie"><region name="Lombardie"><name sortKey="D Arminio Monforte, Antonella" sort="D Arminio Monforte, Antonella" uniqKey="D Arminio Monforte A" first="Antonella" last="D'Arminio Monforte">Antonella D'Arminio Monforte</name></region></country><country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Pradier, Christian" sort="Pradier, Christian" uniqKey="Pradier C" first="Christian" last="Pradier">Christian Pradier</name></region><name sortKey="Thiebaut, Rodolphe" sort="Thiebaut, Rodolphe" uniqKey="Thiebaut R" first="Rodolphe" last="Thiebaut">Rodolphe Thiebaut</name></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name></region></country><country name="Suisse"><region name="Canton de Vaud"><name sortKey="Rickenbach, Martin" sort="Rickenbach, Martin" uniqKey="Rickenbach M" first="Martin" last="Rickenbach">Martin Rickenbach</name></region></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stephane" last="De Wit">Stephane De Wit</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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|texte= Presence of the Metabolic Syndrome Is Not a Better Predictor of Cardiovascular Disease Than the Sum of Its Components in HIV-lnfected Individuals : Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) study
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