Determinants of Metabolic Syndrome Among Patients Receiving Anti-Retro-Viral Treatment in A Tertiary Hospital, Central Ethiopia: Unmatched Case–Control Study

Abstract

Purpose

Scaling up antiretroviral treatment (ART) reduces morbidity and mortality among people living with HIV/AIDS (PLHA). This success is challenged by the constellation of interrelated metabolic disorders such as metabolic syndrome (MetS). Given the changing ART regimens and schedules, increasing patient age and methodological limitations, existing evidence regarding the determinants of MetS remains inconclusive. Therefore, in the current study, we aimed to identify the determinants of MetS in patients receiving ART at a tertiary hospital in central Ethiopia.

Patient and Methods

We conducted an unmatched case–control study that included 393 patients with a case-to-control ratio of 1 to 2. Data were collected by interviewing patients, reviewing charts, physical examinations, and laboratory testing. The data were entered into Epi-Info version 7.2 and analyzed using SPSS version 26. A binary logistic regression analysis was used to identify the determinants of MetS. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to estimate the strength of the association between MetS and its determinants. Statistical significance was set at p-value < 0.05.

Results

In this study, higher odds of developing MetS were identified among patients aged 40–60 years (AOR 3.75; 95% CI: 1.66–8.49) and those older than 60 years (AOR 6.18; 95% CI: 2.12–17.95) than among those aged < 40 years. Similarly, higher odds were observed among patients who frequently consumed animal source foods than among those who consumed cereals or vegetables (AOR, 1.94; 95% CI, 1.03–3.63), those who had HIV lipodystrophy (AOR 1.73; 95% CI: 1.05–2.86), those who were treated with stavudine (AOR 3.08; 95% CI: 1.89–5.04), and those who were treated with zidovudine (AOR 1.71, 95% CI: 1.02–2.88) compared to their counterparts.

Conclusion

Older age, diet from animal sources, exposure to zidovudine or stavudine, and the presence of lipodystrophy were independent determinants of MetS.

Keywords:

• adama
• cardiometabolic
• diabetes
• dyslipidemia
• hypertension
• obesity

Ethics Statement

This work was performed in accordance with the Declaration of Helsinki and has no conflicts of interest. Ethical approval was obtained from the ethics committee of Adama Hospital Medical College. The patients were informed about the purpose of the study, and verbal informed consent was obtained from each of them. The verbal informed consent process was acceptable and approved by the Ethics Committee of Adama Hospital Medical College.

Acknowledgment

We are thankful to our data collectors, laboratory technicians, and supervisors for their contribution to this work. Our sincere appreciation goes to our study participants for consenting and providing us with valuable information, without which this work would not have been realized. Finally, we would like to thank the Adama Comprehensive specialized hospital leaders, ART clinic staff for their unreserved cooperation, and the Adama Hospital Medical College ethical review board for the ethical clearance and approval of our protocol.

Disclosure

The authors report no conflicts of interest in this work.