Dyslipidemia, diet, and physical exercise in children under treatment with anti-retroviral medication in El Salvador: a cross-sectional study.

Background Dyslipidemias are common in HIV-infected children, especially if treated with protease-inhibitors, but there are data on how to treat dyslipidemias in this population. We estimated the dislypidemia prevalence and its association with treatment, diet, and physical exercise in children on anti-retroviral treatment at the El Salvador reference center for pediatric HIV care (CENID). Methods Information was gathered regarding socio-demographic characteristics, treatment, diet, and physical activity of 173 children aged 5-18 years and on anti-retroviral therapy. Triglycerides, total cholesterol, low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), viral load, and CD4 T-lymphocytes were measured. Abnormal concentrations were defined as triglycerides ≥130 mg/dl in 10- to 18-year-olds and ≥100 mg/dl in <10 year-olds; total cholesterol ≥200 mg/dl; LDL-C ≥130 mg/dl; and HDL-C ≤35 mg/dl. We adjusted four different multivariate models to assess the independent association of each type of dyslipidemia with protease-inhibitors, diet, and physical exercise. Results Of the 173 children, 83 (48%) had hypertriglyceridemia and 25 (14.5%) hypercholesterolemia. High LDL-C concentrations were observed in 17 children (9.8%) and low HDL-C in 38 (22%). Treatment with protease-inhibitors was significantly associated with hypertriglyceridemia (Prevalence Ratio (PR) 2.8; 95%CI 2.0-3.8) and hypercholesterolemia (PR 9.0; 95%CI 3.6-22.2). Higher adherence to a “high fat/sugar diet” was associated with hypercholesterolemia (PR 1.6; 95%CI 1.1-2.3) and high LDL-C (PR 1.7; 95%CI 1.0-2.9). Compared with those exercising <3 times/week, children exercising ≥7 times were less likely to have low HDL-C (PR=0.4; 95%CI 0.2-0.7). Conclusions These results suggest that a healthy diet and exercise habits can contribute to controlling some aspects of the lipid profile in this population.

SONEGO Michela;  SAGRADO Maria Jose;  ESCOBAR Gustavo;  LAZZERINI Marzia;  RIVAS Estefanie;  MARTÍN-CAÑAVATE Rocio;  PÉREZ DE LÓPEZ Elsy;  AYALA Sandra;  CASTANEDA Luis;  APARICIO Pilar;  CUSTODIO CEREZALES Estefania; 

2016-10-20

LIPPINCOTT WILLIAMS & WILKINS

JRC101234

0891-3668,   

http://journals.lww.com/pidj/pages/articleviewer.aspx?year=2016&issue=10000&article=00012&type=abstract,    https://publications.jrc.ec.europa.eu/repository/handle/JRC101234,   

10.1097/INF.0000000000001244,