Risk factors for progression from prediabetes to diabetes among older people with HIV.

IF 3.4 2区医学 Q3 IMMUNOLOGY

AIDS Pub Date : 2024-10-01 Epub Date: 2024-06-25 DOI:10.1097/QAD.0000000000003970

Mary Clare Masters, Katherine Tassiopoulos, Yajing Bao, Kunling Wu, Susan L Koletar, Leah H Rubin, Jingyan Yang, Edgar T Overton, Scott Letendre, Todd T Brown, Kristine M Erlandson, Frank J Palella

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引用次数: 0

Abstract

Objective: Risk factors for progression from prediabetes mellitus (pre-DM) to diabetes mellitus (DM) among people with HIV (PWH) receiving modern antiretroviral therapy (ART) require better characterization.

Design: AIDS Clinical Trials Group (ACTG) A5322 (HAILO) was an observational cohort study of PWH ≥40 years old. Participants initiated ART through ACTG randomized clinical trials.

Methods: We used Cox proportional hazards regression models to identify risk factors for development of DM among HAILO participants with pre-DM.

Results: Among 1035 HAILO participants, 74 (7%) had pre-DM at entry and another 679 (66%) developed pre-DM during follow-up. Of 753 PWH with pre-DM, 167 (22%) developed DM. In multivariable models, the risk of developing DM was greater with higher BMI, lower CD4 count (≤200 cells/mm 3 ), hypertriglyceridemia, or higher waist circumference at pre-DM diagnosis ( P < 0.01).

Conclusion: Rates of pre-DM and progression to DM remain high among virally suppressed PWH receiving modern ART regimens. Traditional risks for DM, such as higher BMI or waist circumference, are associated with increased risk of incident DM among PWH with pre-DM. The association between lower CD4 + and progression to DM suggests a role for advanced immunodeficiency and inflammation. Further investigation of interventions aimed at preventing DM among PWH with pre-DM is needed. Optimizing prevention and treatment for DM may be an intervenable opportunity to improve long-term outcomes for PWH.

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感染艾滋病毒的老年人从糖尿病前期发展为糖尿病的风险因素。

目的接受现代抗逆转录病毒疗法（ART）的艾滋病病毒感染者（PWH）从糖尿病前期（pre-DM）发展为糖尿病（DM）的风险因素需要更好的描述：艾滋病临床试验组（ACTG）A5322（HAILO）是一项针对年龄≥40 岁的艾滋病病毒感染者的观察性队列研究。参与者通过 ACTG 随机临床试验开始接受抗逆转录病毒疗法：我们使用 Cox 比例危险度回归模型来确定 HAILO 参与者中发生 DM 的风险因素：在1035名HAILO参与者中，74人（7%）在入组时患有糖尿病前期，另有679人（66%）在随访期间发展为糖尿病前期。在753名有DM前期症状的PWH中，167人（22%）发展为DM。在多变量模型中，体重指数（BMI）越高、CD4 细胞数越低（≤200 cells/ mm3）、高甘油三酯血症或腰围越大的人患糖尿病前期的风险就越高（p 结论：糖尿病前期和病情恶化的发生率与体重指数（BMI）、CD4 细胞数（≤200 cells/ mm3）、高甘油三酯血症和腰围有关：在接受现代抗逆转录病毒疗法的病毒抑制型艾滋病患者中，糖尿病前期和糖尿病进展率仍然很高。传统的糖尿病风险，如较高的体重指数（BMI）或腰围，与糖尿病前期感染者中糖尿病发病风险的增加有关。CD4 较低与糖尿病进展之间的关联表明，晚期免疫缺陷和炎症也起着一定的作用。需要进一步调查旨在预防糖尿病前期的残疾人中发生糖尿病的干预措施。优化DM的预防和治疗可能是改善PWH长期预后的一个可干预机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

期刊介绍： Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.