Document Detail


Multimorbidity patterns in HIV-infected patients: the role of obesity in chronic disease clustering.
MedLine Citation:
PMID:  23023101     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Increases in multimorbidity and obesity have been noted in HIV-infected populations in the current treatment era. Patterns of multimorbid disease clustering and the impact of obesity on multimorbidity are understudied in this population.
METHODS: We examined obesity and multimorbidity patterns among 1844 HIV-infected patients in the UAB 1917 Clinic. Exploratory factor analysis was used to identify the underlying factor structure responsible for clustering. Patterns among the resulting morbidity factors by body mass index (BMI) category were explored. Multivariable logistic regression models were fit to identify predictors of multimorbidity cluster patterns.
RESULTS: The prevalence of multimorbidity was 65% (1205/1844). Prevalence increased with progressive BMI categories from underweight (64%) to obese (79%). Three multimorbidity clusters were identified: "metabolic," including hypertension, gout, diabetes mellitus, and chronic kidney disease (range, 0.41-0.84; P < 0.001); "Behavioral," including mood disorders, dyslipidemia, chronic obstructive pulmonary disease, chronic ulcer disease, osteoarthritis, obstructive sleep apnea, and cardiac disorders (range, 0.32-0.57; P < 0.001); "Substance Use," including alcohol abuse, substance abuse, tobacco abuse, and hepatitis C (range, 0.53-0.89; P < 0.001). Obesity was associated with increased odds of multimorbidity (obese vs. normal BMI category: OR = 1.52, 95% CI: 1.15 to 2.00).
CONCLUSIONS: Three patterns of disease clustering were identified. Obesity was associated with a higher likelihood of multimorbidity. The management of multimorbidity and obesity will need to be addressed in future clinical practice guidelines to enhance long-term outcomes of HIV-infected patients in the current treatment era.
Authors:
David J Kim; Andrew O Westfall; Eric Chamot; Amanda L Willig; Michael J Mugavero; Christine Ritchie; Greer A Burkholder; Heidi M Crane; James L Raper; Michael S Saag; James H Willig
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  61     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-27     Completed Date:  2013-02-04     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  600-5     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adult
Alabama / epidemiology
Body Mass Index
Chronic Disease
Cluster Analysis
Comorbidity
Female
HIV Infections / epidemiology*,  pathology
Humans
Logistic Models
Male
Middle Aged
Obesity / epidemiology*,  pathology
Prevalence
Grant Support
ID/Acronym/Agency:
1K07AG31779/AG/NIA NIH HHS; 1R21HS019516-01/HS/AHRQ HHS; 1R24 AI067039-1/AI/NIAID NIH HHS; 5 T32 HS013852/HS/AHRQ HHS; P30-AI27767/AI/NIAID NIH HHS; R01 AG015062/AG/NIA NIH HHS; R18-HS017786-02/HS/AHRQ HHS; R21 CA124336/CA/NCI NIH HHS; R24 AI067039/AI/NIAID NIH HHS; U2R TW006246/TW/FIC NIH HHS; UB4HP19045//PHS HHS
Comments/Corrections

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