Volume 11 Supplement 1

Abstracts of the Ninth International Congress on Drug Therapy in HIV Infection

Open Access

Statistical agreement between ATPIII, IDF, EGIR, AACE metabolic syndrome classifications in HIV-infected patients and association with lipodystrophy

  • G Guaraldi1,
  • S Zona1,
  • R D'Amico1,
  • N Squillace1,
  • G Orlando1,
  • C Stentarelli1 and
  • R Esposito1
Journal of the International AIDS Society200811(Suppl 1):P125

DOI: 10.1186/1758-2652-11-S1-P125

Published: 10 November 2008

Purpose of the study

To assess statistical agreement of metabolic syndrome (MS) ATPIII, IDF, EGIR and AACE classification in HIV-infected patients and association with body fat redistribution.

Methods

Cross-sectional observational study that included all consecutive HIV-infected patients seen at a metabolic clinic who were screened for MS and had a clinical and radiological lipodystrophy (LD) evaluation. Cohen's Kappa statistic was calculated to assess statistical agreement between different MS classifications. Logistic regression models were performed to identify factors associated with different MS classifications. (Tables 1 and 2.)
Table 1

K of Cohen shows a low level of agreement between MS classifications.

 

EGIR

AACE

NCEP ATP-III

IDF

0.27* (64.61%)

0.07* (56.01%)

0.41* (71.66%)

EGIR

 

0.21* (74.33%)

0.38* (75.74%)

AACE

  

0.35* (81.68%)

*p-value < 0.001 Body fat changes (LD definition and objective anthropometric variables) were included in univariable and multivariable logistic analysis.

Table 2

Variables

ATP-III Adj. OR (95% CI)

P-value

EGIR Adj. OR (95% CI)

P-value

IDF Adj. OR (95% CI)

P-value

Lipoatrophy

1.14 (0.66; 1.96)

0.63

1.20 (0.71; 2.03)

0.49

1.21 (0.79; 1.84)

0.37

Central adiposity

1.87 (0.99; 3.53)

0.054

2.88 (1.64; 4.27)

0.001

2.14 (1.21; 3.79)

0.009

Mixed form

2.06 (1.26; 3.37)

0.004

2.65 (1.64; 4.27)

<0.0001

2.12 (1.43; 3.14)

<0.0001

% fat legs (10%)

1.04 (0.82; 1.32)

0.73

0.73 (0.57; 0.93)

0.013

0.91 (0.74; 1.13)

0.41

VAT/TAT

12.35 (4.84; 31.48)

<0.0001

2.80 (1.16; 6.78)

0.022

2.37 (1.08; 5.21)

0.031

BMI

      

<19

0.33 (0.13; 0.86)

0.024

0.30 (0.12; 0.78)

0.014

0.51 (0.28; 0.92)

0.027

between 19 and 25

Ref.

-

Ref.

-

Ref.

-

between 25 and 30

2.12 (1.51; 2.99)

<0.0001

2.36 (1.70; 3.28)

<0.0001

2.42 (1.76; 3.32)

<0.0001

>30

5.56 (3.04; 10.16)

<0.0001

12.38 (6.28; 24.43)

<0.0001

5.99 (3.02; 11.90)

<0.0001

Summary of results

1,348 pts were included in the analysis.

Figure 1 depicts prevalence of metabolic syndrome according to different definition.

Figure 1

Conclusion

Concordance between MS classification is less than ideal. After adjusting for BMI strata, lipodystrophy phenotypes and central fat accumulation are associated with for MS diagnosis.

Authors’ Affiliations

(1)
University of Modena and Reggio Emilia

Copyright

© Guaraldi et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.

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