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Role of metabolic syndrome components in human immunodeficiency virus-associated stroke

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Abstract

Metabolic syndrome (MetS) is a cluster of risk factors, including elevated mean arterial pressure (MAP), atherogenic dyslipidemia (elevated triglycerides [TRG]), abdominal obesity (increased body mass index [BMI]), glucose intolerance (elevated glucose [GLU]), and prothrombotic/inflammatory state (increases in uric acid [UA]), that are associated with increased risk of cerebrovascular disease. We studied if an association existed between MetS components and human immunodeficiency virus (HIV)-associated cryptogenic strokes—those not caused by HIV complications, endocarditis, or stimulant abuse. We performed a retrospective case-control study. Eleven cryptogenic strokes were identified from 2346 HIV-infected (HFV+) participants. Each case was matched by age, sex, and date of stroke diagnosis to five HIV+ controls without stroke. Nonparametric stratified Wilcoxon ranked sum tests with subsequent mixed effect logistic regression determined the influence of each MetS component on HIV-associated cryptogenic stroke. Although each MetS component appeared higher for HIV+ cases with cryptogenic strokes than HIV+ controls, only MAP (odds ratio [OR] = 5.70, 95% confidence interval [CI] = 1.15–28.3) and UA (OR = 1.88, 95% CI = 1.06–3.32) were statistically different. A significantly higher percentage of HIV-associated cryptogenic stroke cases met criteria for MetS (4/11 = 36%) compared to HIV+ controls (6/55 = 11%). This observational study suggests a possible role for MetS components in HFV+ cryptogenic stroke cases. Although MetS is defined as a constellation of disorders, elevated hypertension and hyperuricemia may be involved in stroke pathogenesis. Reducing MetS component levels in HIV+ patients could therefore protect them from subsequent stroke.

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Authors and Affiliations

  1. Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA

    Beau M. Ances, Debralee Rosario, Terry Alexander & Ronald J. Ellis

  2. Department of Psychiatry, University of California San Diego, La Jolla, California, USA

    Archana Bhatt, Jennifer Marquie-Beck & Igor Grant

  3. Department of Family and Preventative Medicine, University of California San Diego, La Jolla, California, USA

    Florin Vaida

  4. Department of Medicine, University of California San Diego, La Jolla, California, USA

    Scott Letendre & J. Allen McCutchan

  5. 660 South Euclid Avenue, Box 8111, 63110, St. Louis, MO, USA

    Beau M. Ances

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  1. Beau M. Ances
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  2. Archana Bhatt
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  3. Florin Vaida
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  4. Debralee Rosario
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  5. Terry Alexander
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HIV Neurobehavioral Research Center (HNRC) Group

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Correspondence to Beau M. Ances.

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Ances, B.M., Bhatt, A., Vaida, F. et al. Role of metabolic syndrome components in human immunodeficiency virus-associated stroke. Journal of NeuroVirology 15, 249–256 (2009). https://doi.org/10.1080/13550280902962443

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  • DOI: https://doi.org/10.1080/13550280902962443

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