Is diabetes prevalence higher among HIV-infected individuals compared with the general population? Evidence from MMP and NHANES 2009-2010.
Is diabetes prevalence higher among HIV-infected individuals compared with the general population? Evidence from MMP and NHANES 2009-2010.
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DOI：
10.1136/bmjdrc-2016-000304
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发表时间：
2017
影响因子：
4.1
通讯作者：
Skarbinski J
中科院分区：
文献类型：
--
作者：
Hernandez-Romieu AC;Garg S;Rosenberg ES;Thompson-Paul AM;Skarbinski J
在美国，hiv感染的成年人中糖尿病（DM）患病率缺乏具有全国代表性的估计，并且hiv感染的成年人与一般成年人相比是否有更高的糖尿病风险仍然存在争议。我们使用来自医学监测项目（n=8610名艾滋病毒感染者）和国家健康与营养检查调查（n=5604名普通人群）的全国代表性调查（2009-2010年）数据，并拟合logistic回归模型，以确定和比较两种人群中糖尿病的加权患病率，并检查与艾滋病毒感染成年人中糖尿病相关的因素。成年hiv感染者中糖尿病患病率为10.3% （95% CI 9.2% ~ 11.5%）。与普通人群相比，感染艾滋病毒的成年人中糖尿病患病率高3.8% （CI为1.8%至5.8%）。艾滋病毒感染亚组，包括女性（患病率差异5.0%,CI 2.3%至7.7%）、20-44岁个体（4.1%,CI 2.7%至5.5%）和非肥胖个体（3.5%,CI 1.4%至5.6%），与一般成年人相比，糖尿病患病率增加。与HIV感染成人糖尿病相关的因素包括年龄、HIV感染持续时间、几何平均CD4细胞计数和肥胖。10个接受医疗护理的艾滋病毒感染者中有1个患有糖尿病。尽管肥胖增加了艾滋病毒感染者患糖尿病的风险，但与一般成人人群的比较表明，艾滋病毒感染者的糖尿病可能在较早的年龄和没有肥胖的情况下发生。
Nationally representative estimates of diabetes mellitus (DM) prevalence among HIV-infected adults in the USA are lacking, and whether HIV-infected adults are at increased risk of DM compared with the general adult population remains controversial. We used nationally representative survey (2009–2010) data from the Medical Monitoring Project (n=8610 HIV-infected adults) and the National Health and Nutrition Examination Survey (n=5604 general population adults) and fit logistic regression models to determine and compare weighted prevalences of DM between the two populations, and examine factors associated with DM among HIV-infected adults. DM prevalence among HIV-infected adults was 10.3% (95% CI 9.2% to 11.5%). DM prevalence was 3.8% (CI 1.8% to 5.8%) higher in HIV-infected adults compared with general population adults. HIV-infected subgroups, including women (prevalence difference 5.0%, CI 2.3% to 7.7%), individuals aged 20–44 (4.1%, CI 2.7% to 5.5%), and non-obese individuals (3.5%, CI 1.4% to 5.6%), had increased DM prevalence compared with general population adults. Factors associated with DM among HIV-infected adults included age, duration of HIV infection, geometric mean CD4 cell count, and obesity. 1 in 10 HIV-infected adults receiving medical care had DM. Although obesity contributes to DM risk among HIV-infected adults, comparisons to the general adult population suggest that DM among HIV-infected persons may develop at earlier ages and in the absence of obesity.