November 20, 2007

Metabolic Syndrome Increases Risk for Diabetes and Heart Disease After Starting Treatment

People who develop metabolic syndrome after starting HIV treatment have an increased risk of diabetes and heart disease, according to a study published in the November 30 issue of AIDS. Metabolic syndrome includes unhealthy changes in cholesterol, blood sugar and fat accumulation in the waist, and may increase a person’s risk for developing adult onset diabetes and heart disease. Although studies have not found that metabolic syndrome is more common in people with HIV than people who are HIV negative, HIV treatment can cause it.

Sean Emery, PhD, of the National Centre in HIV Epidemiology and Clinical Research at the University of New South Wales in Sydney, Australia, and his colleagues conducted regular measurements of body mass index, hip and waist circumference, and cholesterol and blood sugar in 881 people starting HIV treatment for the first time. They sought to determine whether development of metabolic syndrome after starting HIV treatment would also increase a person’s risk for developing diabetes and/or heart disease. People in the study were randomized to receive Videx (didanosine) plus Zerit (stavudine) and either Sustiva (efavirenz), Viracept (nelfinavir) or Sustiva and Viracept.

Roughly 8 percent of the study participants had metabolic syndrome before starting treatment. Approximately 200 people developed metabolic syndrome after starting treatment, and this increased a person’s risk of developing heart disease by more than 300 percent and diabetes by as much as 434 percent compared with people who did not develop metabolic syndrome. Increases in triglycerides combined with increases in blood sugar and blood pressure were the factors most commonly associated with an increased risk for heart disease. None of the treatment combinations were more likely than the others to lead to the development of metabolic syndrome.

The authors note that overall, the percentage of people with metabolic syndrome in the study is lower than that found in the general population or in other studies of people with HIV, and that this could be because people in this study were generally younger than in other studies and more likely to be female. They also state, however, that this is the first study to assess the development of metabolic syndrome in people starting HIV treatment and its impact on risk for diabetes and heart disease, and that the results suggest that metabolic syndrome should be considered as an important risk factor for both conditions.

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Previous Comments:

derisha, durban, 2008-03-21 08:10:54
does this prevalence exist in south africa where people are below their breadline.. too poor so obesity is not a problem????

What to do, Seattle, 2007-11-29 13:54:34
OK, you're telling us something we already know, how about telling us what we can do about high triglycerides, cholestrol, blood sugars and blood pressure!

kp, maryland, 2007-11-29 11:25:14
i been on my meds now for about 2 years and i notice an increase amont a fat around my waist and under my arms also, my trglycerides levels has increase. i particapted in a fish oil study to lower my triglycerides which help but for as the exceeds fat i was told to increase my excerise and lower my fat and sugar intake. i'm afraid of whats going to happen to my health next.

Wondering, Tollesboro, 2007-11-27 22:50:45
I am not going to make light of these illness both run in my family heavy on both sides but, on the other side of this coin what would happen to those of us with HIV/AIDS without these meds? I have had HIV now AIDS for 18 years and I feel blessed for any drug that can keep me hanging on just a little longer, till they find a cure. All drugs have side effects. I find it a low price to pay when facing death. I know they these can cause death as well but AIDS is a sure one without these meds.

Greg, South Bend, 2007-11-27 09:41:20
So far diet and exercise has not helped me control the metabolic issues that current HIV meds cause. The next step for me is surgery because nothing else has worked. There needs to be more research on the cause, prevention and treatment of metabolic syndromes

special sista, Oxon Hill,MD, 2007-11-26 20:45:09
I do believe that a lot of the HIV meds causes a lot of health issues. However, I founded exercising, eating a lot of veg drinking lots of water,living stress free and praising God for just another day of your health and strengh helps. Yes by keeping your weight down will prevent a lot of these issues.

sophia e, san francisco, 2007-11-22 01:16:15
What I would like researched and/or written about is how to prevent metabolic syndrome. I believe it can be prevented via changes in diet, activity and (overall) lifestyle.

Gerda Hoggins, SOUTH AFRICA, 2007-11-21 01:08:23
My Husband was on videx and Zerit, and today he has Diabetes. He is 62 years old and got HIV in 2002, his CD 4 Count is 265, he is not on any medicatition at this stage the Dr is waiting for his CD 4 count to go down to 200, i wish i knew when is the best time to go on the HIV tablets, yes he is on diabetes treatment.You have to have a CD 4 off 200 in SA before you can have treatment in the mean time his sugar is between 7.9 and 9 everyday he is on a low GI diet. I love Poz and Aidsmed it helps.