A Comparison of Metabolic Outcomes between Obese HIV-Exposed Uninfected Youth from the PHACS SMARTT Study and HIV-Unexposed Youth from the NHANES Study in the United States

Jennifer Jao*, Denise L. Jacobson, Wendy Yu, William Borkowsky, Mitchell E. Geffner, Elizabeth J. McFarland, Kunjal Patel, Paige L. Williams, Tracie Miller

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background:Metabolic perturbations in HIV-exposed uninfected (HEU) obese youth may differ from those in the general obese pediatric population.Methods:Metabolic parameters of obese (body mass index Z-score >95th percentile) HEU youth in the Pediatric HIV/AIDS Cohort Study (PHACS) Surveillance Monitoring of ART Toxicities (SMARTT) study were compared with a matched sample of obese youth from the US National Health and Nutrition Examination Survey (NHANES). We evaluated systolic and diastolic hypertension (blood pressure ≥90th percentile for age, sex, and height), total cholesterol >200 mg/dL, high-density lipoprotein cholesterol <35 mg/dL, low-density lipoprotein cholesterol >130 mg/dL, triglycerides (TGs) >150 mg/dL, and Homeostatic Model Assessment-Insulin Resistance >4.0. Modified Poisson regression models were fit to quantify the prevalence ratio (PR) of each outcome comparing the 2 cohorts, adjusting for confounders.Results:The blood pressure outcome analytic subgroup included 1096 participants (n = 304 HEU), the total cholesterol and high-density lipoprotein cholesterol subgroup 1301 participants (n = 385 HEU), and the low-density lipoprotein cholesterol, TG, and Homeostatic Model Assessment-Insulin Resistance subgroup 271 (n = 83 HEU). After adjustment, obese HEU youth had a higher prevalence of systolic and diastolic hypertension [PR = 3.34, 95% confidence interval (CI): 2.48 to 4.50; PR = 2.04, 95% CI: 1.18 to 3.52, respectively], but lower prevalence of insulin resistance (PR = 0.67, 95% CI: 0.54 to 0.85) and hypercholesterolemia (PR = 0.67, 95% CI: 0.44 to 1.01) compared with obese NHANES youth.Conclusions:In the United States, obese HEU youth seem to have an increased risk of hypertension, but lower risk of insulin resistance and hypercholesterolemia, compared with a general obese pediatric population. Monitoring for cardiovascular morbidity in adulthood may be warranted in HEU children.

Original languageEnglish (US)
Pages (from-to)319-327
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Volume81
Issue number3
DOIs
StatePublished - Jul 1 2019

Keywords

  • HIV-exposed uninfected children
  • cholesterol
  • hypertension
  • insulin resistance
  • lipids
  • metabolic
  • obesity

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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