Role of metabolic syndrome components in HIV-associated sensory neuropathy

Beau M. Ances, Florin Vaida, Debralee Rosario, Jennifer Marquie-Beck, Ronald J. Ellis, David M. Simpson, David B. Clifford, Justin C. McArthur, Igor Grant, J. Allen McCutchan

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

OBJECTIVES:: Sensory neuropathy is a common peripheral nerve complication of HIV infection and highly active antiretroviral therapy. Metabolic syndrome (MetS), a cluster of risk factors for atherosclerosis and microvascular disease, is associated with sensory neuropathy in HIV-uninfected (HIV-negative) persons. We examined whether MetS or its components predispose individuals to HIV-associated sensory neuropathy (HIV-SN). DESIGN:: From a prospective multicenter cohort of 1556 HIV-positive patients, a subgroup (n = 130) with fasting laboratory tests and sensory neuropathy assessment was selected. METHODS:: Sensory neuropathy was defined by symmetrically decreased reflexes or sensation loss in the legs. MetS was defined by presence of at least three risk factors: mean arterial pressure of at least 100 mmHg; triglycerides (TRGs) of at least 150 mg/dl and high-density lipoprotein cholesterol of less than 40 mg/dl for male patients, less than 50 mg/dl for female patients; body mass index of more than 25 kg/m; plasma glucose (GLU) of at least 100 mg/dl and self-reported diabetes mellitus type 2. Multivariate logistic regression examined the association between HIV-SN and MetS. RESULTS:: After controlling for HIV-SN risk factors such as age, CD4 current, length of HIV infection, use of dideoxynucleoside reverse transcriptase inhibitors and protease inhibitors, MetS was not associated with HIV-SN (P = 0.72). However, when each MetS component was assessed, elevated TRG was a significant risk factor for HIV-SN. From the larger cohort, both diabetes mellitus type 2 (odds ratio = 1.4, P < 0.01) and elevated TRG (odds ratio = 1.4, P = 0.01) were risk factors for HIV-SN. CONCLUSION:: The risk of HIV-SN was increased for diabetes mellitus type 2 and elevated TRG but not for other MetS components. Both increase the risk of sensory neuropathy in HIV-populations, but the mechanism(s) remains unclear.

Original languageEnglish
Pages (from-to)2317-2322
Number of pages6
JournalAIDS
Volume23
Issue number17
DOIs
StatePublished - Nov 2009

Keywords

  • HIV
  • Highly active antiretroviral therapy
  • Metabolic syndrome
  • Sensory neuropathy

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