Cardiometabolic Status of Adults Living with HIV in Colon, Panama

巴拿马结肠州成人艾滋病毒感染者的心脏代谢状况

基本信息

批准号：
10772743
负责人：
Humberto López Castillo
金额：
$ 9.82万
依托单位：
UNIVERSITY OF CENTRAL FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10772743
关键词：
Acquired Immunodeficiency Syndrome Address Administrative Supplement Adult Affect Area Award COVID-19 pandemic Cardiovascular Diseases Caribbean region Central America Central obesity Cities Clinic Clinical Colon Continuity of Patient Care Country Data Diabetes Mellitus Diagnosis Discrimination Disease Environment Epidemiologic Methods Epidemiology Evaluation Evidence based intervention Fogarty International Center Functional disorder Funding Future General Population Goals Guidelines HIV HIV Infections Health Healthcare High Density Lipoprotein Cholesterol High Prevalence Hospitals Hyperglycemia Hypertension Hypertriglyceridemia Incentives Income Infection Inflammatory Information Dissemination Institution Intervention Laboratories Latin America Longevity Mediating Metabolic Diseases Metabolic syndrome Methodology Morbidity - disease rate Non-Insulin-Dependent Diabetes Mellitus Outcome Panama Parents Patients Persons Population Population Heterogeneity Populations at Risk Positioning Attribute Prevalence Province Research Research Activity Research Priority Research Project Grants Resources Rest Risk Factors Series Services Sexual and Gender Minorities Side Site Source Strategic Planning Subgroup Therapeutic Therapeutic Effect Transportation Uninsured United States National Institutes of Health antiretroviral therapy cardiometabolism cohort diagnostic criteria epidemiologic data evidence base evidence based guidelines experience follow-up gender minority group health management improved innovation interest low and middle-income countries mortality prevent protective factors recruit social stigma sociodemographic variables sociodemographics

项目摘要

PROJECT SUMMARY Worldwide, metabolic syndrome (MetS) affects one-quarter of adults, increasing morbidity and mortality due to general causes and especially due to type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). MetS is becoming hyperendemic and, despite its important health outcomes, it remains underrecognized, underdiagnosed, and undertreated. As adults living with HIV (ALWH) have normalized their lifespan with advancements in antiretroviral therapy (ART), there is an epidemiologic shift towards noncommunicable diseases, such as MetS, with prevalence rates comparable to or higher than the general population. There is considerable paucity of clinical, laboratory, and epidemiologic data on MetS among ALWH in low- and middle-income countries. Panama, a middle-income country, has the highest prevalence rate of HIV in Central America and the third highest in Latin America, but does not routinely keep track of noncommunicable diseases among ALWH. Thus, this study proposes to describe the cardiometabolic profile and 1-year trajectory among ALWH in the Caribbean province of Colón and to determine sociodemographic, laboratory, and therapeutic moderators of such effect. As an exploratory objective, we also will explore the feasibility and sustainability of local, evidence-based guidelines to prevent and treat MetS among ALWH, with the long-term goal of developing a culturally appropriate, evidence-based intervention to prevent, diagnose, treat, and follow-up MetS among ALWH in Panama and adapt it for the rest of Latin America. Such intervention must be informed with the baseline MetS epidemiology and the risk and protective factors among ALWH, while building research and clinical capacity and buy-in from key local stakeholders. Thus, in this study, we aim to: 1. Estimate the overall prevalence and 12-month trajectory of MetS and its five diagnostic criteria (i.e., abdominal obesity, hypertriglyceridemia, reduced HDL cholesterol, hypertension, and hyperglycemia) among ALWH in Colón, Panama. 2. Describe and estimate the overall effect of therapeutic, laboratory, and socio-demographic variables on the prevalence and trajectory of MetS its five diagnostic criteria in ALWH in Colón, Panama. 3. Adapt clinical and preventative MetS guidelines to implement a pilot, clinical workflow for the assessment and treatment of MetS in ALWH in Colón, Panama, and evaluate its feasibility, acceptability, sustainability within the ART Clinic’s local capacity.

项目概要在世界范围内，代谢综合征 (MetS) 影响四分之一的成年人，导致发病率和死亡率增加由于一般原因，尤其是 2 型糖尿病 (DM2) 和心血管疾病 (CVD)。 MetS 正在变得高度流行，尽管它具有重要的健康结果，但它仍然未被充分认识到，随着艾滋病毒感染者 (ALWH) 的寿命正常化，其诊断和治疗不足。随着抗逆转录病毒治疗（ART）的进步，流行病学转向非传染性疾病疾病，例如 MetS，其患病率与普通人群相当或更高。低水平和低水平 ALWH 中 MetS 的临床、实验室和流行病学数据相当缺乏中等收入国家巴拿马是中部地区艾滋病毒感染率最高的国家。美洲和拉丁美洲排名第三，但不定期跟踪非传染性疾病因此，本研究旨在描述 ALWH 的心脏代谢特征和 1 年轨迹。加勒比科隆省的 ALWH 并确定社会人口统计、实验室和治疗作为探索性目标，我们还将探讨这种效应的可行性和可持续性。预防和治疗 ALWH 中 MetS 的本地循证指南，长期目标是制定一种文化上适当、基于证据的干预措施，用于预防、诊断、治疗和随访 MetS 巴拿马的 ALWH 并使其适用于拉丁美洲其他地区，此类干预措施必须了解基线。 MetS 流行病学以及 ALWH 的风险和保护因素，同时建立研究和临床因此，在这项研究中，我们的目标是： 1. 估计 MetS 的总体患病率和 12 个月轨迹及其五个诊断标准（即，腹部肥胖、高甘油三酯血症、高密度脂蛋白胆固醇降低、高血压和高血糖）巴拿马科隆的 ALWH。 2. 描述并估计治疗、实验室和社会人口变量对治疗的总体影响巴拿马科隆 ALWH 中 MetS 的五项诊断标准的患病率和轨迹。 3. 调整临床和预防性 MetS 来实施评估的试点临床工作流程指南巴拿马科隆 ALWH 的 MetS 治疗和治疗，并评估其可行性、可接受性和可持续性在 ART 诊所的当地能力范围内。