Low Aspartate Aminotransferase/Alanine Aminotransferase Ratio As an Indicator of Metabolic Syndrome Among HIV Patients on Dolutegravir Therapy in Southwestern Uganda

Overview

Journal Cureus

Date 2025 Feb 10

PMID 39925575

Authors

Daniel Nzaramba

Charles Nkubi Bagenda

Hope Mudondo

Jazira Tumusiime

Elastus Ssemwanga

Darlington Muhwezi

Sylvia Achieng Lumumba

Ritah Kiconco

Simon Peter Rugera

Affiliations

Soon will be listed here.

Abstract

Purpose: This study aimed to investigate the association between the aspartate aminotransferase-to-alanine aminotransferase (AST/ALT) ratio and metabolic syndrome (MetS) among HIV-infected patients on dolutegravir-based antiretroviral therapy (ART).

Patients And Methods: A cross-sectional study was conducted on 377 adults on dolutegravir-based ART for at least one year. Data were collected from July 1 to August 15, 2024. Participants were systematically sampled, data were collected using a pre-tested questionnaire, anthropometric measurements were taken, and blood samples were collected for biochemical analysis. A low AST/ALT ratio was defined as ≤ 1 and MetS as the presence of at least three of the following: central obesity, fasting hyperglycemia, elevated triglycerides, low HDL-C, and hypertension (International Diabetes Federation (IDF) Consensus worldwide definition, 2006). Logistic regression was used to assess the association between low AST/ALT ratio and MetS, and receiver operating curve (ROC) analysis was conducted to evaluate its predictive performance.

Results: The median age of the participants was 44 years (interquartile range (IQR): 30-59), with 56.2% being female. The prevalence of MetS was 35.3% (133/377, 95%CI: 30.6-40.3). A significant association was found between low AST/ALT ratio and MetS (aOR: 2.19, 95% CI: 1.28-3.73, p = 0.004). Female gender (adjusted odds ratio (aOR): 3.68, 95% CI: 2.07-6.55, p < 0.001) and smoking (aOR: 3.96, 95% CI: 1.77-8.86, p < 0.001) were also significantly associated with MetS. The ALT/AST ratio had a significant predictive power for MetS (AUC = 0.583, 95% CI: 0.523-0.643).

Conclusion: The prevalence of MetS is high. A low AST/ALT ratio is significantly associated with MetS, making it a potential biomarker among HIV patients on ART.

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