Obesity and dyslipidemia in behaviorally HIV-infected young women: Adolescent Trials Network study 021.

TitleObesity and dyslipidemia in behaviorally HIV-infected young women: Adolescent Trials Network study 021.
Publication TypePublication
Year of Publication2010
AuthorsMulligan K, D Harris R, Monte D, Stoszek S, Emmanuel P, Hardin DS, Kapogiannis BG, Worrell C, Meyer WA, Sleasman J, Wilson CM, Aldrovandi GM
Corporate AuthorsAdolescent Trials Network 021 Protocol Team
JournalClin Infect Dis
Volume50
Issue1
Pagination106-14
Date Published2010 Jan 01
ISSN1537-6591
KeywordsAdolescent, Anthropometry, Body Mass Index, C-Reactive Protein, Cross-Sectional Studies, Dyslipidemias, Female, HIV Infections, Humans, Least-Squares Analysis, Lipids, Obesity, Risk Factors, Young Adult
Abstract

<p><b>BACKGROUND: </b>The goal of this study was to determine the nature and prevalence of abnormalities in lipids, glucose metabolism, and body composition in behaviorally human immunodeficiency virus (HIV)-infected young women and the relationship of these abnormalities to different classes of antiretroviral therapy regimens.</p><p><b>METHODS: </b>We conducted a cross-sectional, multicenter study involving 173 behaviorally HIV-infected women aged 14-24 years and 61 HIV-seronegative control subjects. HIV-infected women were categorized as follows: antiretroviral therapy naive (n=85), receiving a regimen containing a nonnucleoside reverse-transcriptase inhibitor (NNRTI; n=33), receiving a regimen containing a protease inhibitor (PI; n=36), or receiving a regimen not containing an NNRTI or a PI (n=19). Measurements included fasting lipid levels, glucose and insulin levels before and 2 hours after an oral glucose challenge, high-sensitivity C-reactive protein (hsCRP) levels, anthropometry, fat distribution (measured by dual energy X-ray absorptiometry), and antiretroviral therapy and medical histories. Race-adjusted results were compared across groups and within HIV-infected groups.</p><p><b>RESULTS: </b>The median age of participants was 20 years. Of HIV-infected subjects, 77% were African American, 35% smoked cigarettes, and 32% reported exercising regularly. More than 40% had a body mass index > or =25. Triglycerides; total, high-density lipoprotein (HDL), and non-HDL cholesterol; and hsCRP levels differed significantly among groups, with higher levels being most common among those receiving antiretroviral therapy. Indices of glucose metabolism did not differ among groups. In general, cholesterol levels, hsCRP levels, and indices of glucose metabolism worsened as body mass index increased.</p><p><b>CONCLUSIONS: </b>Obesity, dyslipidemia, and inflammation were prominent among HIV-infected adolescent women and, coupled with other risk factors, may accelerate the lifetime risk of cardiovascular disease and other adverse events. These results underscore the need for a multifaceted approach to addressing risk reduction in this population.</p>

DOI10.1086/648728
Alternate JournalClin. Infect. Dis.
PubMed ID19947855
PubMed Central IDPMC2939739
Grant ListU01 HD 040533 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD 040474 / HD / NICHD NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
M01 RR00240 / RR / NCRR NIH HHS / United States
U01 HD040497 / HD / NICHD NIH HHS / United States
M01 RR165001 / RR / NCRR NIH HHS / United States
M01 RR000071 / RR / NCRR NIH HHS / United States
M01 RR00043 / RR / NCRR NIH HHS / United States
M01 RR001271 / RR / NCRR NIH HHS / United States
U01 HD040533-01 / HD / NICHD NIH HHS / United States
M01 RR000043 / RR / NCRR NIH HHS / United States
R60 MC00003 / / PHS HHS / United States
M01 RR00071 / RR / NCRR NIH HHS / United States
U01 HD040470 / HD / NICHD NIH HHS / United States
M01 RR000240 / RR / NCRR NIH HHS / United States