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Cardiometabolic markers to identify cardiovascular disease risk in HIV-infected black South Africans
Insights
High triglycerides to HDL-C ratio, high total cholesterol to HDL-C ratio, and low HDL-C levels are key indicators of cardiovascular disease risk in South African adults living with HIV.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Sub-Saharan Africa, particularly South Africa, has the highest prevalence of HIV globally.
- People living with HIV face elevated cardiovascular disease (CVD) risk due to chronic inflammation, metabolic changes, and lipodystrophy, beyond traditional risk factors.
Purpose of the Study:
- To develop a screening discriminant model for identifying critical CVD risk factors in HIV-infected individuals.
- To analyze CVD risk in a cohort of 140 HIV-positive Black Africans in South Africa's North West Province.
Main Methods:
- Collected anthropometric measures, blood pressure, and pulse wave velocity.
- Analyzed blood for lipid profiles (total cholesterol, HDL-C, LDL-C, triglycerides) and glucose levels.
- Employed Partial Least Squares Discriminant Analysis, Student's t-tests, and chi-squared tests for statistical analysis.
Main Results:
- A triglycerides to HDL-C ratio ≥ 1.49 indicated CVD risk.
- A total cholesterol to HDL-C ratio ≥ 5.4 was associated with increased CVD risk.
- HDL-C levels ≤ 0.76 mmol/l were identified as a significant CVD risk indicator.
Conclusions:
- Specific lipid level ratios and HDL-C levels serve as valuable indicators for CVD risk assessment in HIV-positive Black Africans.
- These findings have significant public health implications for managing CVD risk in this vulnerable population.
Background:
The prevalence of HIV is the highest in sub-Saharan Africa; South Africa (SA) is one of the most affected countries with the highest number of adults living with HIV infection in the world. Besides the traditional risk factors for cardiovascular disease (CVD) in the general population, in people living with HIV there are specific factors - chronic inflammation, metabolic changes associated with the infection, therapy, and lipodystrophy - that potentially increase the risk for developing CVD.
Objective:
This study proposes a screening discriminant model to identify the most important risk factors for the development of CVD in a cohort of 140 HIV-infected black Africans from the North West Province, SA.
Methods:
Anthropometric measures, systolic blood pressure, diastolic blood pressure and the carotid-dorsalis pedis pulse wave velocity were determined. Blood was analysed to determine the levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triglycerides (TGs) and glucose. Partial least squares discriminant analysis was performed as a supervised pattern recognition method. Independent Student's t-tests were further employed to compare the means of risk factors on interval scales; for comparison of categorical risk factors between groups, chi2 tests were used.
Results:
A TG:HDL-C ratio > or = 1.49, TC:HDL-C ratio > or = 5.4 and an HDL-C level < or = 0.76 mmol/l indicated CVD risk in this cohort of patients living with HIV.
Conclusion:
The results have important health implications for black Africans living with HIV as these lipid levels may be a useful indicator of the risk for CVD.
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