Triglyceride paradox in Nigerians living with HIV

Objective: To achieve early detection of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs), the concept of metabolic syndrome (MetS) was designed as a mathematical construct with diagnosis made when three out of five features are present. However, racial differences exist in the predictive value of MetS in identifying risk of T2DM and CVD. Whilst the prevalence of MetS is higher in Whites than Blacks, Blacks show a higher prevalence of T2DM, hypertension and CVDs. This discordance may be due to the fact that while Whites display the classic pattern of elevated triglyceride (TG) and low HDL-C, Blacks usually have normal TG in the presence of low HDL-C, the so-called “triglyceride paradox”. We determined the presence of triglyceride paradox in people living with Human Immunodeficiency Virus (PLWHA) in whom there is little or no earlier report of this phenomenon. Methodology: This cross-sectional study evaluated the lipid pattern of 265 PLWHA. Results: Low HDL-C with normal TG was found in 127 (47.9%) while 19 (7.2%) had low HDL-C and elevated TG. Low HDL-C with normal TG was found in 7 (29.2%) and 15 (55.6%) of sub-cohorts with diabetes and hypertension respectively. MetS was present in 31 (11.7%) participants and low HDL-C and normal TG was the most common lipid pattern 17 (54.8%) in them. Conclusion: Low HDL-C and normal TG was the most common lipid pattern. This calls for longitudinal studies to re-define the cut-off point of TG level used in PLWHA in order to improve the predictive value of MetS in the early diagnosis of CVDs and T2DM.