Interleukin-6, high sensitivity C-reactive protein, and the development of type 2 diabetes among HIV-positive patients taking antiretroviral therapy.
Interleukin-6, high sensitivity C-reactive protein, and the development of type 2 diabetes among HIV-positive patients taking antiretroviral therapy.
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DOI：
10.1097/qai.0000000000000354
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发表时间：
2014-12-15
期刊：
影响因子：
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通讯作者：
ESPRIT Study Groups
中科院分区：
文献类型：
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作者：
Béténé A Dooko C;De Wit S;Neuhaus J;Palfreeman A;Pepe R;Pankow JS;Neaton JD;INSIGHT SMART;ESPRIT Study Groups
HIV infection is associated with increased levels of inflammatory markers. Inflammation is hypothesized to play a role in the development of type 2 diabetes. Data addressing this issue among HIV positive participants are limited. A cohort of 3,695 participants without diabetes, taking antiretroviral therapy and with an average CD4+ count 523 cells/mm3 were followed for an average of 4.6 years. Diabetes risk associated with baseline levels of high sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) was assessed using Cox proportional hazards regression models. Analyses considered baseline levels of factors associated with diabetes risk and HIV-related measures. 137 patients developed diabetes requiring drug treatment during follow-up (8.18 per 1,000 person years). Median levels of IL-6 and hsCRP were significantly higher among those who developed diabetes compared to those who did not: 3.45 versus 2.50 pg/ml for IL-6 and 4.91 versus 3.29 μg/ml for hsCRP (P<.001). Adjusted hazard ratios (HRs) associated with a doubling of IL-6 and hsCRP were 1.29 (95% CI: 1.08-1.55; P=0.005) and 1.22 (95% CI: 1.10-1.36; P<0.001), respectively. Body mass index (P<0.001), age (P=0.013), co-infection with hepatitis B or C (P=0.03), non-smoking status (P=0.034), and use of lipid-lowering treatment (P=0.008) were also associated with an increased risk of diabetes. These findings indicate that low-grade systemic inflammation is an underlying factor in the pathogenesis of diabetes.
