Association between asprosin and metabolic syndrome in people living with human immunodeficiency virus: A case–control study

The lifespan of people living with human immunodeficiency virus (PLWH) has been extended following antiretroviral therapy, which, paradoxically, has increased the burden of metabolic syndrome (MS). Asprosin has emerged as a novel biomarker strongly associated with MS and other metabolic indicators. This study aimed to investigate the relationship between serum asprosin levels and MS in PLWH. This prospective case-control study enrolled 111 PLWH with MS and 111 PLWH without MS as controls. A 1:1 propensity score matching was performed to adjust for potential confounding factors, including age and antiretroviral therapy regimen. Serum asprosin levels and other clinical variables were measured. PLWH with MS exhibited significantly higher serum asprosin levels compared to those without MS (19.2 [14.2-24.4] vs 15.4 [11.4-18.1] ng/mL, respectively, P < .001). Multivariate logistic regression analysis confirmed that elevated serum asprosin levels (odds ratios = 1.239, 95% confidence interval: 1.063-1.445, P = .006) were associated with MS in this population. Notably, the use of integrase strand transfer inhibitors was associated with the highest serum asprosin levels, followed by non-nucleoside reverse transcriptase inhibitors and protease inhibitors (17.8 [13.3-21.8] vs 16.6 [10.5-22.9] vs 16 [12, 18.7] ng/mL, respectively, P = .006). Sensitivity analyses confirmed the robustness of the associations between serum asprosin levels and MS across different subgroups. Serum asprosin levels are significantly higher in PLWH with MS than those without. Additionally, the use of integrase strand transfer inhibitors was strongly associated with elevated serum asprosin levels. These findings provide novel clinical insights into the role of asprosin in the pathogenesis of MS in PLWH.