Risk of diabetes mellitus in HIV-infected patients receiving highly active antiretroviral therapy
Risk of diabetes mellitus in HIV-infected patients receiving highly active antiretroviral therapy
复制标题
接受高效抗逆转录病毒治疗的艾滋病毒感染者患糖尿病的风险
作者：
Shi;Chun;Chang;Tsai;N. Ko;Zhi
摘要以往的研究表明，在人类免疫缺陷病毒（HIV）感染的患者中，长期接受高效抗逆转录病毒治疗（HAART）的糖尿病（DM）的发病率增加。然而，在HAART时代，亚洲HIV感染患者中与糖尿病相关的因素仍不清楚。一项全国性队列研究数据来自台湾国家健康保险研究数据库（NHIRD）2000年至2010年期间的数据，用于调查HIV感染患者中糖尿病的发病率和相关因素。进行倾向评分匹配，以匹配4797例接受HAART的患者（HAART队列）和4797例未接受HAART的患者（非HAART队列）。HAART的使用被视为考克斯回归模型中的时间依赖性变量。HAART队列的10年DM发病率（7.16%; 95%可信区间[CI]，4.30%-10.03%）显著高于非HAART队列（2.24%; 95% CI，1.28%-3.20%）（P <0.001）。 调整年龄、性别和合并症后，接受HAART与DM发病率增加相关，亚分布风险比（sHR）为2.39（95%CI，1.65-3.45）。高血压（sHR = 5.27; 95%CI，3.21-8.65）、痛风（sHR = 2.39; 95%CI，1.38-4.16）和丙型肝炎病毒（HCV）感染（sHR = 2.43; 95%CI，1.28-4.61）与糖尿病的高风险显著相关。 敏感性分析显示，HAART暴露与DM风险增加显著相关，特别是在那些没有预先存在的高血压、痛风或HCV感染的患者中。暴露于HAART增加了台湾HIV感染患者的糖尿病风险，特别是那些没有预先存在的高血压，痛风或HCV感染的患者。
Abstract Previous studies have shown that the incidence of diabetes mellitus (DM) has increased in human immunodeficiency virus (HIV)-infected patients with long-term exposure to highly active antiretroviral therapy (HAART). However, the factors associated with DM among HIV-infected patients in Asia remain unclear in the HAART era. A nationwide cohort study Data from Taiwan's National Health Insurance Research Database (NHIRD) between 2000 and 2010 were used to investigate the incidence of and factors associated with DM among HIV-infected patients. Propensity score matching was conducted to match 4797 patients receiving HAART (HAART cohort) with 4797 patients not receiving HAART (non-HAART cohort). HAART use was treated as a time-dependent variable in a Cox regression model. HAART cohort had a significantly higher 10-year incidence of DM (7.16%; 95% confidence interval [CI], 4.30%–10.03%) than non-HAART cohort (2.24%; 95% CI, 1.28%–3.20%) (P < .001). After adjusting for age, gender, and comorbidities, receiving HAART was associated with an increased incidence of DM, with a subdistribution hazard ratio (sHR) of 2.39 (95% CI, 1.65–3.45). Hypertension (sHR = 5.27; 95% CI, 3.21–8.65), gout (sHR = 2.39; 95% CI, 1.38–4.16), and hepatitis C virus (HCV) infection (sHR = 2.43; 95% CI, 1.28–4.61) were significantly associated with a higher risk of DM. Sensitivity analyses showed exposure to HAART remained significantly associated with an increased risk of DM, particularly in those without pre-existing hypertension, gout, or HCV infection. Exposure to HAART increased the risk of DM in HIV-infected Taiwanese patients, particularly in those without pre-existing hypertension, gout, or HCV infection.
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影响因子：
39
作者：
Freiberg MS;Chang CC;Kuller LH;Skanderson M;Lowy E;Kraemer KL;Butt AA;Bidwell Goetz M;Leaf D;Oursler KA;Rimland D;Rodriguez Barradas M;Brown S;Gibert C;McGinnis K;Crothers K;Sico J;Crane H;Warner A;Gottlieb S;Gottdiener J;Tracy RP;Budoff M;Watson C;Armah KA;Doebler D;Bryant K;Justice AC
通讯作者：
Justice AC
影响因子：
--
作者：
Brown, TT;Cole, SR;Dobs, AS
通讯作者：
Dobs, AS
影响因子：
25.7
作者：
White DL;Ratziu V;El-Serag HB
通讯作者：
El-Serag HB
影响因子：
45.3
作者：
Dignam, James J.;Kocherginsky, Maria N.
通讯作者：
Kocherginsky, Maria N.