Diabetes prevalence by HbA1c and oral glucose tolerance test among HIV-infected and uninfected Tanzanian adults.

Autor: Jeremiah K; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania., Filteau S; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Faurholt-Jepsen D; Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark., Kitilya B; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania., Kavishe BB; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania., Krogh-Madsen R; Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Olsen MF; Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark., Changalucha J; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania., Rehman AM; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Range N; Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania., Kamwela J; Tanzania Commission for AIDS, Dar es Salaam, Tanzania., Ramaiya K; Hindu Mandal Hospital, Dar es Salaam, Tanzania., Andersen AB; Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark., Friis H; Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark., Heimburger DC; Vanderbilt Institute for Global Health and Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America., PrayGod G; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2020 Apr 08; Vol. 15 (4), pp. e0230723. Date of Electronic Publication: 2020 Apr 08 (Print Publication: 2020).
DOI: 10.1371/journal.pone.0230723
Abstrakt: Background: The burden of diabetes is increasing in sub-Saharan Africa, including among people living with HIV. We assessed the prevalence of diabetes and the roles of HIV, antiretroviral therapy (ART) and traditional risk factors among adults in Tanzania.
Methods: We analysed diabetes-relevant baseline data from 1,947 adult participants in the CICADA study in Mwanza, Tanzania: 655 HIV-uninfected, 956 HIV-infected ART-naïve, and 336 HIV-infected persons on ART. WHO guidelines for haemoglobin A1c (HbA1c) and oral glucose tolerance test (OGTT) were used to define diabetes and prediabetes. Risk factors were evaluated using multinomial logistic regression analysis. Relative risk ratios (RRR) were generated comparing participants with diabetes and prediabetes against the reference of those with no diabetes.
Results: Mean age was 41 (SD 12) years; 59% were women. The prevalence of diabetes was 13% by HbA1c and 6% by OGTT, with partial overlap among participants identified by the two tests. Relative to HIV-uninfected, HIV-infected ART-naïve persons had increased relative risks of diabetes (HbA1c: RRR = 1.95, 95% CI 1.25-3.03; OGTT: RRR = 1.90, 95% CI 0.96-3.73) and prediabetes (HbA1c: RRR = 2.89, 95% CI 1.93-4.34; OGTT: RRR = 1.61, 95% CI 1.22-2.13). HIV-infected participants on ART showed increased risk of prediabetes (RRR 1.80, 95% CI 1.09, 2.94) by HbA1c, but not diabetes. CD4 count < 200 cell/μL at recruitment increased risk and physical activity decreased risk of diabetes by both HbA1c and OGTT.
Conclusions: The prevalence of diabetes was high, especially among HIV-infected ART-naïve adults. Being more physically active was associated with lower risk of diabetes. HbA1c and OGTT identified different participants as having diabetes or prediabetes. Overall, the finding of high burden of diabetes among HIV-infected persons suggests that health systems should consider integrating diabetes screening and treatment in HIV clinics to optimize the care of HIV patients and improve their health outcomes.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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