Total cholesterol/high-density lipoprotein cholesterol ratio is a significant predictor of metabolic syndrome among people on dolutegravir-based antiretroviral therapy: A cross-sectional study in southwestern Uganda

Abstract

Objective: The total cholesterol/high-density lipoprotein cholesterol ratio is a predictor of nonalcoholic fatty liver disease—a hepatic manifestation of metabolic syndrome. This study investigated the association between total cholesterol/high-density lipoprotein cholesterol ratio and metabolic syndrome among people living with human immunodeficiency virus on dolutegravir-based antiretroviral therapy in southwestern Uganda. Methods: We conducted a secondary analysis of data obtained from a cross-sectional study of 377 adults who had been on dolutegravir-based antiretroviral therapy for at least 1 year at Ruhoko Health Centre IV, southwestern Uganda. Results: The median total cholesterol/high-density lipoprotein cholesterol ratio was significantly higher in individuals with metabolic syndrome (3.92) than in those without (2.96, p < 0.001). A statistically significant association was observed between high total cholesterol/high-density lipoprotein cholesterol ratio and metabolic syndrome (adjusted odds ratios: 2.06, 95% confidence interval: 1.08–3.91, p ¼ 0.028). The total cholesterol/high-density lipoprotein cholesterol ratio at an optimal cutoff of 3.30 had a significant ability (area under the curve ¼ 0.696, 95% confidence interval: 0.642–0.750) to differentiate participants with metabolic syndrome from those without at a sensitivity of 73% and specificity of 60%. Conclusion: The total cholesterol/high-density lipoprotein cholesterol ratio is a significant predictor of metabolic syndrome and serves as a potential blood-based biomarker.