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OBJECTIVE: Prevalence of chronic complications of HIV infection is increasing and early recognition and treatment of the components of metabolic syndrome (MS) are essential to prevent cardiovascular and metabolic complications. Considering this, we performed a cross-sectional study on the prevalence and risk-factors for MS among HIV-infected subjects. METHODS: A total of 819 patients followed at a large outpatient HIV unit were assessed by an interviewer-administered questionnaire that recorded several demographic, epidemiologic, clinical, laboratory, and social variables. Lipodystrophy diagnosis relied on agreement between patient's self-report and physician's observation of altered body-fat deposits. The presence of three or more of the following characteristics identified MS: increased waist circumference, hypertriglyceridemia, low HDL cholesterol level, hypertension, and hyperglycemia. We used logistic regression analyses to study variables independently associated with MS. RESULTS: The prevalence of MS was 20.6% and that of lipodystrophy was 38.5%. 61 (36.1%) out of 169 patients with MS had also lipodystrophy. Patients with metabolic syndrome were significantly more likely to be older (OR = 1.08), had higher CD4 counts (OR = 1.001), had an increased body mass index (OR = 1.27) and had longer exposure to antiretroviral therapy (OR = 1.01) than those without metabolic syndrome. CONCLUSION: Both traditional risk factors for cardiovascular disease and factors associated with HIV infection itself, such as an increased CD4 cell count and a longer exposure to antiretroviral therapy, seem to be associated with metabolic syndrome in the present study population. OBJETIVO: A prevalência de complicações crônicas da infecção HIV está aumentando, e o reconhecimento precoce e o tratamento dos componentes da síndrome metabólica (SM) são essenciais para a prevenção de complicações cardiovasculares e metabólicas. Considerando isso, realizamos um estudo transversal sobre prevalência e fatores de risco para SM em indivíduos HIV+. MÉTODOS: Um total de 819 pacientes acompanhados em um ambulatório de HIV foi avaliado por um entrevistador que registrou em questionário dados demográficos, epidemiológicos, clínicos, laboratoriais e variáveis sociais. O diagnóstico de lipodistrofia baseou-se na concordância entre autorrelato do paciente e observação do médico das alterações de gordura corporal. A SM foi identificada pela presença de três ou mais das seguintes características: circunferência abdominal aumentada, hipertrigliceridemia, colesterol HDL baixo, hipertensão e hiperglicemia. Análises de regressão logística foram utilizadas para identificar variáveis associadas à SM. RESULTADOS: A prevalência de SM foi 20,6% e de lipodistrofia foi 38,5%. Entre os 169 pacientes com SM, 61 (36,1%) apresentavam lipodistrofia. Os pacientes com síndrome metabólica tinham, significativamente, maior probabilidade de ser mais velhos (OR = 1,08), ter maior contagem de CD4 (OR = 1,001), ter maior índice de massa corporal (OR = 1,27) e ter maior tempo de exposição à terapia antirretroviral (OR = 1,01). CONCLUSÃO: Tanto fatores de risco tradicionais para doença cardiovascular quanto fatores associados à infecção HIV, como aumento da contagem de CD4 e maior exposição à terapia antirretroviral, parecem estar associados à SM na população estudada

What should we know about metabolic syndrome and lipodystrophy in AIDS?