Prevalence of obesity and disturbances in glucose homeostasis in HIV‐infected subjects and general population – missed diagnoses of diabetes?
| Autor: | Anna Hanttu, K J Kauppinen, K Liitsola, Pia Kivelä, P Koponen, Jussi Sutinen, J. Ollgren, P Jousilahti |
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| Přispěvatelé: | Infektiosairauksien yksikkö, HUS Inflammation Center, Helsinki University Hospital Area, University of Helsinki, HUS Internal Medicine and Rehabilitation, Department of Medicine, Clinicum |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Blood Glucose medicine.medical_specialty obesity IMPACT Population HIV Infections general population DISEASE MELLITUS 03 medical and health sciences 0302 clinical medicine Insulin resistance impaired fasting glucose Risk Factors Internal medicine Diabetes mellitus medicine Prevalence Glucose homeostasis Homeostasis Humans Pharmacology (medical) 030212 general & internal medicine education Original Research RISK 2. Zero hunger INSULIN-RESISTANCE education.field_of_study Missed Diagnosis business.industry Health Policy HIV medicine.disease Impaired fasting glucose 030112 virology Comorbidity Obesity A1C WEIGHT-GAIN 3. Good health Infectious Diseases 3121 General medicine internal medicine and other clinical medicine diabetes mellitus COMORBIDITY business Body mass index |
| Zdroj: | HIV Medicine |
| ISSN: | 1468-1293 1464-2662 |
| Popis: | Objectives Comparative data on glucose disorders using fasting blood samples between people living with HIV (PLWH) and the general population are lacking. The objective of this study was to compare the prevalence and risk factors of obesity and disturbances in glucose homeostasis between PLWH treated with modern antiretroviral therapy and the general population. Methods Adjusted prevalence of obesity, features of insulin resistance (triglyceride:high-density lipoprotein cholesterol ratio and alanine aminotransferase), impaired fasting glucose (IFG), diabetes mellitus (DM) and combined dysglycaemia (presence of IFG or DM) were determined using fasting blood samples among 1041 PLWH and 7047 subjects representing the general population. Results People living with HIV had a lower prevalence of obesity [18.2%, 95% confidence interval (CI): 15.1-21.2 vs. 23.9%, 95% CI: 22.4-25.4], but a higher prevalence of insulin resistance and IFG (20.0%, 95% CI: 16.6-23.4 vs. 9.8%, 95% CI: 8.7-10.8) than the general population. Fasting glucose concentration was higher, but glycated haemoglobin (HbA1c) was lower, among PLWH. Prevalence of dysglycaemia for a given body mass index (BMI) was higher in PLWH than in the general population. The prevalence of DM did not differ between PLWH (13.2%, 95% CI: 10.2-15.9) and the general population (14.5%, 95% CI: 13.6-15.4). Conclusions The prevalence of obesity was lower, but the risk of dysglycaemia for a given BMI was significantly higher, among PLWH, highlighting the importance of prevention and treatment of obesity among HIV-infected subjects. Regardless of the increased prevalence of insulin resistance and IFG, DM was surprisingly not more common among PLWH, raising concern about the under-diagnosis of DM, possibly due to low sensitivity of HbA1c in this patient population. |
| Databáze: | OpenAIRE |
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