Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the Multicenter AIDS Cohort Study
Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the Multicenter AIDS Cohort Study
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DOI：
10.1001/archinte.165.10.1179
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发表时间：
2005-05-23
影响因子：
--
通讯作者：
Dobs, AS
中科院分区：
文献类型：
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作者：
Brown, TT;Cole, SR;Dobs, AS
背景资料：糖尿病（DM）在人类免疫缺陷病毒（HIV）感染的患者接受高效抗逆转录病毒疗法（HAART）的风险尚未得到很好的defined.Methods：我们进行了分析，在多中心艾滋病队列研究，以确定糖尿病的患病率和发病率在这个队列的HIV感染和HIV血清阴性的男性。患病率分析包括1278名男性（710名HIV血清阴性和568名HIV感染者，411名接受HAART），基线时测定空腹血糖浓度。发病率分析包括这1278名男性中的680名，他们在基线访视时空腹血糖浓度为98 mg/dL（5.4 mmol/L）或更低，没有自我报告的DM病史，也没有自我报告的抗糖尿病药物使用情况。糖尿病定义为空腹血糖浓度126 mg/dL结果：在基线访视时，411名使用HAART的HIV感染男性中有57名（14%）患有DM，而711名HIV血清阴性男性中有33名（5%）患有DM（患病率=4.6; 95%可信区间为3.0-7.1，经年龄和体重指数调整[计算方法为体重（千克）除以身高（米）的平方]）。在使用HAART的HIV感染男性中，糖尿病的发病率为4.7例/100人年，而在HIV血清阴性男性中为1.4例/100人年（率比= 4.11; 95%置信区间，1.85-9.16，经年龄和体重指数调整），在4年的观察期内，基于中位随访2.3年。在接受HAART治疗的HIV感染男性中，DM的发病率是HIV血清阴性男性的4倍以上，这表明风险高于先前的估计。
Background: The risk of diabetes mellitus (DM) in human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy (HAART) has not been well defined.Methods: We conducted an analysis in the Multicenter AIDS Cohort Study to determine the prevalence and incidence of DM in this cohort of HIV-infected and HIV-seronegative men. Prevalence analysis included 1278 men (710 HIV seronegative and 568 HIV infected, 411 receiving HAART) with fasting glucose concentration determinations at baseline. Incidence analysis included 680 of these 1278 men who at the baseline visit had a fasting glucose concentration of 98 mg/dL (5.4 mmol/L) or less, no self-reported history of DM, and no self-reported use of antidiabetic medication. Diabetes mellitus was defined as a fasting glucose concentration of 126 mg/dL (7 mmol/L) or higher, self-reported diagnosis of DM, or self-reported use of antidiabetic medication.Results: Fifty-seven (14%) of the 411 HIV-infected men using HAART at the baseline visit had prevalent DM compared with 33 (5%) of the 711 HIV-seronegative men (prevalence ratio=4.6; 95% confidence interval, 3.0-7.1, adjusted for age and body mass index [calculated as weight in kilograms divided by the square of height in meters]). The rate of incident DM was 4.7 cases per 100 person-years among HIV-infected men using HAART compared with 1.4 cases per 100 person-years among HIV-seronegative men (rate ratio = 4.11; 95% confidence interval, 1.85-9.16, adjusted for age and body mass index), during the 4-year observation period, based on a median follow-up of 2.3 years.Conclusion: The incidence of DM in HIV-infected men with HAART exposure was greater than 4 times that of HIV-seronegative men, representing a risk that is higher than previous estimates.