Banca de DEFESA: MARCILENE GLAY VIANA PESSOA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : MARCILENE GLAY VIANA PESSOA
DATE: 30/01/2024
TIME: 16:00
LOCAL: https://meet.google.com/ngu-epdd-qin e LAPEBIOS (Estádio Universitário da UFAL)
TITLE:

ASSOCIATION BETWEEN ANTHROPOMETRIC INDICATORS AND CARDIOVASCULAR RISK DETECTED BY THE SCORE OF FRAMINGHAM RISK IN PEOPLE LIVING WITH HIV

KEY WORDS:

HIV; Anthropometry; Body fat distribution; Lipodystrophy; Cardiovascular risk.

PAGES: 91
BIG AREA: Ciências da Saúde
AREA: Nutrição
SUMMARY:

HIV can lead to immunodeficiency, with antiretroviral therapy (ART) being an effective treatment for inhibiting the virus and preserving the immune function of people living with HIV (PLHIV). However, the viral action and adverse effects of pharmacological therapy can cause metabolic and morphological changes, increasing the risk of cardiovascular issues. In this regard, the assessment of body composition using anthropometric indicators is crucial in clinical practice due to its potential association with morbidity and mortality in PLHIV. The aim of this study was to analyze the association between anthropometric indicators and cardiovascular risk in PLHIV. It is an analytical, cross-sectional observational study conducted in two infectious disease outpatient clinics in Alagoas. The study included cisgender adults (≥18 years) of both sexes with a diagnosis of HIV infection receiving outpatient care. Sociodemographic information, personal history, anthropometric measurements (body mass, height, neck circumference, waist and hip circumference, from which 11 anthropometric indicators were calculated), viral load, CD4+ T lymphocytes, ART regimen and duration, time since diagnosis, biochemical data (blood glucose, total cholesterol, and HDL-c), and blood pressure were collected. The Framingham score was used to calculate cardiovascular risk based on variables such as gender, age, smoking, diabetes mellitus, and treatment for systemic arterial hypertension. Multivariable regression analyses were performed using STATA® v. 13.0 (p<0.05). A total of 354 PLHIV participated in the study, with 41.2% females, an average age of 42.7 ± 13.0 years, 23.8% using protease inhibitors (PIs), 71.3% with undetectable viral load, and an average of 566.4 ± 314.5 mm3 CD4+ T lymphocytes, with 79 individuals immunosuppressed and 246 without immunosuppression. Among the participants,70.1% (n=248) had a low cardiovascular risk, 16.7% (n=59) had moderate risk, and 13.3% (n=47) had high risk. Anthropometric indicators showed stronger correlations with cardiovascular risk compared to biochemical variables and blood pressure. HIVpositive men exhibited higher association coefficients than HIV-positive women. Among the anthropometric indicators analyzed by multivariable regression, adjusted for covariates (education, physical activity level, income, ART, and CD4+ T lymphocytes), the conicity index (CI), waist-to-hip ratio (WHR), body shape index (BSI), waist-to-height ratio (WHtR), and body roundness index (BRI) were the ones significantly related to risk, only in men (β*=0.4985; β*=0.4861; β*=0.4645; β*=0.4320; β*=0.4204, respectively, are the standardized betas of the indicators). No indicator showed an association with women. The anthropometric indicators CI and WHR in HIV-positive men, but not in women, are independently associated with cardiovascular risk, regardless of HIV-related clinical factors, and they exhibited stronger associations (based on effect size), with WHR being the indicator with the most potential application in clinical practice.

COMMITTEE MEMBERS:
Externo(a) à Instituição - DIEGO AUGUSTO SANTOS SILVA - UFSC
Interno(a) - 4364569 - FABIANA ANDREA MOURA
Presidente - 1926612 - LUIZ RODRIGO AUGUSTEMAK DE LIMA