TY - JOUR
T1 - Hyperglycemia and insulin function in antiretroviral treatment-naive HIV patients in Ethiopia: A potential new entity of diabetes in HIV?
AU - Faurholt-Jepsen, Daniel
AU - Olsen, Mette Frahm
AU - Andersen, Anna Birkmose
AU - Kæstel, Pernille
AU - Abdissa, Alemseged
AU - Amare, Hiwot
AU - Yilma, Daniel
AU - Girma, Tsinuel
AU - Tesfaye, Markos
AU - Andersen, Åse Bengård
AU - Friis, Henrik
AU - Jørgensen, Marit Eika
N1 - CURIS 2019 NEXS 227
PY - 2019
Y1 - 2019
N2 - Background: Although diabetes is more common in HIV patients, the direct link between HIV and diabetes is unknown. Glucose abnormalities should be assessed among antiretroviral treatment (ART)-naive patients to reduce confounding by ART. We assessed diabetes status, insulin function and association with inflammation among Ethiopian ART-naive HIV patients.Methods: Among HIV patients initiating ART, we used glycosylated hemoglobin (HbA1c) and oral glucose tolerance test (OGTT) to define prediabetes and diabetes. Insulin during OGTT was determined to calculate insulin function, and C-reactive protein and α1-acid glycoprotein were used as same-day markers of inflammation.Results: Among 332 HIV patients, mean (SD) age was 32.9 (8.8) years, and 222 (66.9%) were women. None had known diabetes, but we found diabetes prevalence using OGTT and HbA1c to be 7.6 and 8.5%, respectively. C-reactive protein and α1-acid glycoprotein were positively associated with hyperglycemia and insulin deficiency, but not insulin resistance. We found poor correlation between traditional risk factors (age and anthropometry) and diabetes, but participants generally had low BMI and waist circumference.Conclusion: ART-naive Ethiopian HIV patients had a high prevalence of prediabetes and diabetes, with a poor agreement between HbA1c and OGTT. Diabetes was associated with inflammation, but not with adiposity and age. Diabetes was linked to insulin deficiency, rather than insulin resistance, which may represent a different entity than type 1 and 2 diabetes. This has implications for choice of drugs, when managing diabetes in African HIV patients.
AB - Background: Although diabetes is more common in HIV patients, the direct link between HIV and diabetes is unknown. Glucose abnormalities should be assessed among antiretroviral treatment (ART)-naive patients to reduce confounding by ART. We assessed diabetes status, insulin function and association with inflammation among Ethiopian ART-naive HIV patients.Methods: Among HIV patients initiating ART, we used glycosylated hemoglobin (HbA1c) and oral glucose tolerance test (OGTT) to define prediabetes and diabetes. Insulin during OGTT was determined to calculate insulin function, and C-reactive protein and α1-acid glycoprotein were used as same-day markers of inflammation.Results: Among 332 HIV patients, mean (SD) age was 32.9 (8.8) years, and 222 (66.9%) were women. None had known diabetes, but we found diabetes prevalence using OGTT and HbA1c to be 7.6 and 8.5%, respectively. C-reactive protein and α1-acid glycoprotein were positively associated with hyperglycemia and insulin deficiency, but not insulin resistance. We found poor correlation between traditional risk factors (age and anthropometry) and diabetes, but participants generally had low BMI and waist circumference.Conclusion: ART-naive Ethiopian HIV patients had a high prevalence of prediabetes and diabetes, with a poor agreement between HbA1c and OGTT. Diabetes was associated with inflammation, but not with adiposity and age. Diabetes was linked to insulin deficiency, rather than insulin resistance, which may represent a different entity than type 1 and 2 diabetes. This has implications for choice of drugs, when managing diabetes in African HIV patients.
KW - Faculty of Science
KW - Diabetes
KW - Glycosylated hemoglobin
KW - HIV
KW - Insulin deficiency
KW - Insulin resistance
KW - Opportunistic infection
U2 - 10.1097/QAD.0000000000002249
DO - 10.1097/QAD.0000000000002249
M3 - Journal article
C2 - 31306166
VL - 33
SP - 1595
EP - 1602
JO - AIDS
JF - AIDS
SN - 1350-2840
IS - 10
ER -