Incidence and associated factors of type 2 diabetes mellitus onset in the Brazilian HIV/AIDS cohort study.

Autor:	Cassenote AJF; Medical Demography Study Group (MDSG), Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Discipline of Labor Market and Physician's Health, Santa Marcelina Faculty, São Paulo, SP, Brazil., Grangeiro A; Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Escuder MM; Health Institute, São Paulo State Department of Health, São Paulo, Brazil., Abe JM; Institute for Advanced Studies, Universidade de São Paulo, São Paulo, SP, Brazil., Santos RD; Heart Institute (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Segurado AC; Department and Division of Infectious and Parasitic Diseases, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: segurado@usp.br.
Jazyk:	angličtina
Zdroj:	The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases [Braz J Infect Dis] 2021 Jul-Aug; Vol. 25 (4), pp. 101608. Date of Electronic Publication: 2021 Aug 31.
DOI:	10.1016/j.bjid.2021.101608
Abstrakt:	Background: People living with HIV (PLH) under combined antiretroviral therapy (cART) are at risk of developing type 2 diabetes mellitus (T2DM). Objective: We examined the incidence of T2DM, associated factors and mean time to outcome in PLH under cART. Method: Data for this multicenter cohort study were obtained from PLH aged over 18, who started cART in 13 Brazilian sites from 2003 to 2013. Factors associated with incident T2DM were evaluated by Cox multiple regression models. Results: A total of 6724 patients (30,997.93 person-years) were followed from January 2003 to December 2016. A T2DM incidence rate of 17.3/1000 person-years (95%CI 15.8-18.8) was observed. Incidence of isolated hypertriglyceridemia and impaired fasting glucose (IFG) were 84.3 (95%CI 81.1-87.6) and 14.5/1000 person-years (95%CI 13.2-15.9), respectively. Mean time to T2DM onset was 10.5 years (95%CI 10.3-10.6). Variables associated with incident T2DM were age 40-50 [Hazard Ratio (HR) 1.7, 95%CI 1.4-2.1] and ≥ 50 years (HR 2.4, 95%CI 1.9-3.1); obesity (HR 2.1, 95%CI 1.6-2.8); abnormal triglyceride/HDL-cholesterol ratio (HR 1.8, 95%CI 1.51-2.2). IFG predicted T2DM (HR 2.6, 95%CI 1.7-2.5) and occurred on average 3.3 years before diabetes onset. Exposure to stavudine for ≥ 2 years was independently associated with incident T2DM [HR 1.6, 95%CI 1.0-2.2). Conclusion: Brazilian PLH under cART are at significant risk of developing T2DM and share risk factors for diabetes onset with the general population, such as older age, obesity, and having metabolic abnormalities at baseline. Moreover, stavudine use was independently associated with incident T2DM. Identifying PLH at a higher risk of T2DM can help caretakers trigger health promotion and establish specific targets for implementation of preventive measures. Competing Interests: Conflicts of interest RDS declares conflicts of interest - honoraria related to consulting, research and/or activity as speaker for the following pharmaceutical companies: Ache, Amgen, Astra Zeneca, Esperion, Kowa, Novo-Nordisk, Merck, MSD, Pfizer, PTC and Sanofi/Regeneron. The other authors declare no conflicting interests. (Copyright © 2021. Published by Elsevier España, S.L.U.)
Databáze:	MEDLINE
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