Journal of NeuroVirology

, Volume 15, Issue 3, pp 249–256

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

  • Beau M. Ances
  • Archana Bhatt
  • Florin Vaida
  • Debralee Rosario
  • Terry Alexander
  • Jennifer Marquie-Beck
  • Ronald J. Ellis
  • Scott Letendre
  • Igor Grant
  • J. Allen McCutchan
  • HIV Neurobehavioral Research Center (HNRC) Group
Article

DOI: 10.1080/13550280902962443

Cite this article as:
Ances, B.M., Bhatt, A., Vaida, F. et al. Journal of NeuroVirology (2009) 15: 249. doi:10.1080/13550280902962443

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.

Keywords

HIVmetabolic syndromestroke

Copyright information

© Journal of NeuroVirology, Inc. 2009

Authors and Affiliations

  • Beau M. Ances
    • 1
    • 5
  • Archana Bhatt
    • 2
  • Florin Vaida
    • 3
  • Debralee Rosario
    • 1
  • Terry Alexander
    • 1
  • Jennifer Marquie-Beck
    • 2
  • Ronald J. Ellis
    • 1
  • Scott Letendre
    • 4
  • Igor Grant
    • 2
  • J. Allen McCutchan
    • 4
  • HIV Neurobehavioral Research Center (HNRC) Group
  1. 1.Department of NeurologyWashington University in St. LouisSt. LouisUSA
  2. 2.Department of PsychiatryUniversity of California San DiegoLa JollaUSA
  3. 3.Department of Family and Preventative MedicineUniversity of California San DiegoLa JollaUSA
  4. 4.Department of MedicineUniversity of California San DiegoLa JollaUSA
  5. 5.St. LouisUSA