Association between systemic inflammation and incident diabetes in HIV-infected patients after initiation of antiretroviral therapy.
Association between systemic inflammation and incident diabetes in HIV-infected patients after initiation of antiretroviral therapy.
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DOI：
10.2337/dc10-0633
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发表时间：
2010-10
期刊：
影响因子：
16.2
通讯作者：
McComsey GA
中科院分区：
文献类型：
--
作者：
Brown TT;Tassiopoulos K;Bosch RJ;Shikuma C;McComsey GA
确定HIV抗逆转录病毒治疗（ART）开始后的全身炎症是否与糖尿病的发生相关。我们进行了一项巢式病例对照研究，将55名在ART开始后48周发生糖尿病的既往ART初治个体（病例受试者）与55名在可比随访期间未发生糖尿病的个体（对照受试者）进行比较，基线BMI和种族/种族匹配。在治疗开始（第0周）和1年后（第48周），分析储存的血浆样本的高敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）和可溶性肿瘤坏死因子-α受体（sTNFR 1和sTNFR 2）水平。病例组受试者年龄大于对照组受试者（中位年龄41岁vs. 37岁，P = 0.001），但两组在其他方面具有可比性。除hs-CRP外，所有标志物的中位水平从第0周至第48周均降低。在校正基线标志物水平、年龄、第48周BMI、第48周CD 4计数（200个细胞/mm 3）和茚地那韦使用后，第48周hs-CRP、sTNFR 1和sTNFR 2水平较高的受试者随后发生糖尿病的几率增加< vs. >（所有P趋势≤ 0.05）。进一步调整第48周血糖后，效应减弱，仅sTNFR 1保持显著性（比值比，最高四分位数vs.最低23.2 [95% CI 1.28-423]，P = 0.03）。ART开始后48周的炎症标志物与糖尿病风险增加相关。这些研究结果表明，全身炎症可能有助于糖尿病的发病机制中艾滋病毒感染的患者。
To determine whether systemic inflammation after initiation of HIV-antiretroviral therapy (ART) is associated with the development of diabetes. We conducted a nested case-control study, comparing 55 previously ART-naive individuals who developed diabetes 48 weeks after ART initiation (case subjects) with 55 individuals who did not develop diabetes during a comparable follow-up (control subjects), matched on baseline BMI and race/ethnicity. Stored plasma samples at treatment initiation (week 0) and 1 year later (week 48) were assayed for levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and the soluble receptors of tumor necrosis factor-α (sTNFR1 and sTNFR2). Case subjects were older than control subjects (median age 41 vs. 37 years, P = 0.001), but the groups were otherwise comparable. Median levels for all markers, except hs-CRP, decreased from week 0 to week 48. Subjects with higher levels of hs-CRP, sTNFR1, and sTNFR2 at 48 weeks had an increased odds of subsequent diabetes, after adjustment for baseline marker level, age, BMI at week 48, CD4 count at week 48 (< vs. >200 cells/mm3), and indinavir use (all Ptrend ≤ 0.05). After further adjustment for week 48 glucose, effects were attenuated and only sTNFR1 remained significant (odds ratio, highest quartile vs. lowest 23.2 [95% CI 1.28–423], P = 0.03). Inflammatory markers 48 weeks after ART initiation were associated with increased risk of diabetes. These findings suggest that systemic inflammation may contribute to diabetes pathogenesis among HIV-infected patients.
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影响因子：
8.2
作者：
Hivert, M. F.;Sun, Q.;Shrader, P.;Mantzoros, C. S.;Meigs, J. B.;Hu, F. B.
通讯作者：
Hu, F. B.
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Dobs, AS
影响因子：
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作者：
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通讯作者：
Grinspoon, SK
影响因子：
15.8
作者：
Kuller LH;Tracy R;Belloso W;De Wit S;Drummond F;Lane HC;Ledergerber B;Lundgren J;Neuhaus J;Nixon D;Paton NI;Neaton JD;INSIGHT SMART Study Group
通讯作者：
INSIGHT SMART Study Group