Trends in diabetes incidence and associated risk factors among people with HIV in the current treatment era.
Journal
AIDS (London, England)
ISSN: 1473-5571
Titre abrégé: AIDS
Pays: England
ID NLM: 8710219
Informations de publication
Date de publication:
01 11 2022
01 11 2022
Historique:
pubmed:
12
8
2022
medline:
1
10
2022
entrez:
11
8
2022
Statut:
ppublish
Résumé
To examine type 2 diabetes mellitus incidence and associated risk factors among people with HIV (PWH). A retrospective clinical cohort study of PWH at a Southeastern US academic HIV clinic between 2008 and 2018. PWH who attended at least two clinic visits were evaluated with demographic and clinical data extracted from the electronic medical record (EMR). Diabetes was defined as: hemoglobin A1C ≥6.5% and/or 2 glucose results >200 mg/dl (at least 30 days apart), diagnosis of diabetes in the EMR, or exposure to diabetes medication. Time to diabetes incidence was computed from the entire clinic population for each year. Multivariable Cox proportional hazard regression models with time-dependent covariates were created to evaluate the independent association between covariates and time to incident diabetes. Among 4113 PWH, we identified 252 incident cases of diabetes. Incidence increased from 1.04 incidents per 1000 person years (PY) in 2008, to 1.55 incidents per 1000 PY in 2018. Body mass index (hazard ratio [HR] 10.5 (6.2, 17.7)), liver disease (HR 1.9 (1.2, 3.1)), steroid exposure (HR 1.5 (1.1, 1.9)), and use of integrase inhibitors (HR 1.5 (1.1, 2.0)) were associated with incident diabetes. Additional associated factors included lower CD4 + cell counts, duration of HIV infection, exposure to nonstatin lipid-lowering therapy, and dyslipidemia. Rapidly increasing incident diabetes rates among PWH were associated with both traditional and HIV-related associated risk factors, particularly body weight, steroid exposure, and use of Integrase Inhibitors. Notably, several of the risk factors identified are modifiable and can be targeted for intervention.
Identifiants
pubmed: 35950938
doi: 10.1097/QAD.0000000000003348
pii: 00002030-202211010-00008
pmc: PMC9529800
mid: NIHMS1827236
doi:
Substances chimiques
Anti-HIV Agents
0
Glycated Hemoglobin A
0
Integrase Inhibitors
0
Lipids
0
Glucose
IY9XDZ35W2
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1811-1818Subventions
Organisme : NIAID NIH HHS
ID : P30 AI027767
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK056336
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK079626
Pays : United States
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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