Prevalence of metabolic syndrome assessed by IDF and NCEP ATP 111 criteria and determinants of insulin resistance among HIV patients in the Eastern Cape Province of South Africa

Aims: To determine the prevalence of metabolic syndrome ( MS) and insulin resistance (IR) and their determinants in HIV on ART, ART naive HIV and HIV negative patients. Methods: Cross sectional study. ART experienced HIV, ART naive HIV and HIV negative patients were compared for differences in prevalence of MS and IR. Determinants of MS and IR were assessed. Results: Prevalence of MS by NCEP criteria was 26.6%, 15.7% and 21.9% (P = 0.3) respectively for HIV on ART, ART naive HIV and HIV negative groups. The MS rates with the IDF definition were 22.7%, 23.2% and 19.3% (P = 0.8) for HIV on ART, ART naive HIV and HIV negative patients respectively. Increased waist circumference by IDF criteria (P = 0.03), visceral to subcutaneous fat ratio (P = 0.049), hypertriglyceredemia (P < 0.001) and high LDL-Cholesterol (P < 0.001) were more common in HIV patients on ART than other groups. IR was found in 12.8%, 3.6% and 2.4% (P = 0.003) of HIV on ART, ART naive HIV and HIV negative groups respectively. Male gender (odds ratio (OR) 11 95% CI 3-48; P < 0.001) was independently associated with MS. HIV patients on ART (OR 6.6 95% CI 1.3-32.3; P = 0.020), IDF definition of MS (OR 3.4 95% CI 1.1-10.7; P = 0.040), NCEP definition of MS (OR 3.2 95% CI 1.01-10.3; P = 0.049) and low HDL-Cholesterol (OR 5.7 95% CI 1.2-27; P = 0.029) were independently associated with IR. Conclusion: Prevalence of MS with IDF and NCEP definitions was similar across groups. HIV patients on ART and MS were independently associated with IR while male gender was independently associated with MS. (C) 2010 Diabetes India. Published by Elsevier Ltd. All rights reserved.