Multicenter Cohort Study of Diabetes Mellitus and Impaired Fasting Glucose in HIV-Infected Patients in China

Zhang, Cheng-Da; Chow, Felicia C.; Han, Yang; Xie, Jing; Qiu, Zhifeng; Guo, Fang; Li, Yanling; Wang, Huanling; Li, Taisheng

doi:10.1097/qai.0000000000000474

Cited by 13 publications

(13 citation statements)

References 63 publications

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“…Notably, our findings are identical to those of a recent meta‐analysis that found a global diabetes incidence in PLHIV of 13.7 per 1000 PY . This falls within the range of those reported in other studies of PLHIV in the region . The incidence of diabetes in our study is substantially higher than in the general population of countries represented in TAHOD‐LITE.…”

Section: Discussionsupporting

confidence: 90%

“…Studies from Taiwan, Thailand and Korea have shown increased FPG levels, indicating diabetes or prediabetes, in 31, 21 and 10% of their HIV‐positive study populations, respectively . Other available data show relatively high diabetes incidence rates of approximately 26, 13 and 5 per 1000 person‐years (PY) after ART initiation in China, Taiwan and Thailand, respectively . These findings suggest that diabetes‐associated morbidity and mortality may be a growing burden in PLHIV in the Asia‐Pacific region, especially as PLHIV are living longer and endure long‐term exposure to ART.…”

Section: Introductionmentioning

confidence: 96%

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Diabetes, mortality and glucose monitoring rates in the TREAT Asia HIV Observational Database Low Intensity Transfer (TAHOD‐LITE) study

et al. 2019

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Objectives Diabetes is a growing cause of morbidity and mortality in people living with HIV (PLHIV) receiving antiretroviral therapy (ART). We investigated the association between fasting plasma glucose (FPG) levels and mortality, and factors associated with FPG monitoring rates in Asia. Methods Patients from the Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) HIV Observational Database Low Intensity Transfer (TAHOD‐LITE) cohort were included in the present study if they had initiated ART. Competing risk and Poisson regression were used to analyse the association between FPG and mortality, and assess risk factors for FPG monitoring rates, respectively. FPG was categorized as diabetes (FPG ≥ 7.0 mmol/L), prediabetes (FPG 5.6–6.9 mmol/L) and normal FPG (FPG < 5.6 mmol/L). Results In total, 33 232 patients were included in the analysis. Throughout follow‐up, 59% had no FPG test available. The incidence rate for diabetes was 13.7 per 1000 person‐years in the 4649 patients with normal FPG at ART initiation. Prediabetes [sub‐hazard ratio (sHR) 1.32; 95% confidence interval (CI) 1.07–1.64] and diabetes (sHR 1.90; 95% CI 1.52–2.38) were associated with mortality compared to those with normal FPG. FPG monitoring increased from 0.34 to 0.78 tests per person‐year from 2012 to 2016 (P < 0.001). Male sex [incidence rate ratio (IRR) 1.08; 95% CI 1.03–1.12], age > 50 years (IRR 1.14; 95% CI 1.09–1.19) compared to ≤ 40 years, and CD4 count ≥ 500 cells/μL (IRR 1.04; 95% CI 1.00–1.09) compared to < 200 cells/μL were associated with increased FPG monitoring. Conclusions Diabetes and prediabetes were associated with mortality. FPG monitoring increased over time; however, less than half of our cohort had been tested. Greater resources should be allocated to FPG monitoring for early diabetic treatment and intervention and to optimize survival.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 96%

Diabetes, mortality and glucose monitoring rates in the TREAT Asia HIV Observational Database Low Intensity Transfer (TAHOD‐LITE) study

et al. 2019

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“…Some studies have showed that the prevalence of metabolic syndrome was higher among HIV-infected patients on ART than among non-HIV-infected healthy controls (15.8 vs. 3.2%) [3]. A high incidence of diabetes mellitus (DM) and impaired fasting glucose (IFG) has been detected in HIV-infected patients receiving ART [4,5]. Another studies have found relationship between some classes of antiretroviral (ARV) drugs such as protease inhibitors (PIs) and nucleos(t)ide retrotranscriptase inhibitors (NRTIs) with a higher frequency of new-onset DM and IFG [6].…”

mentioning

confidence: 99%

Dyslipidemia and Fasting Glucose Impairment among HIV-Infected Patients 48-Weeks after the First Antiretroviral Regimen

Marín¹

2015

J AIDS Clin Res

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BackgroundWith the increased survival of HIV-infected patients, there have emerged a number of unexpected consequences of chronic illness and drugs adverse events, especially in the form of metabolic disease [1].Available data suggest the presence of an accelerated process of coronary atherosclerosis in this population due to multiple factors, including a higher prevalence (compared with non-HIV-infected patients) of conventional risk factors, emerging risk factors (chronic inflammation, immune activation, and senescence related to HIV infection itself), and the role of antiretroviral therapy (ART), regarding metabolic syndrome as one of the major problems [2]. Some studies have showed that the prevalence of metabolic syndrome was higher among HIV-infected patients on ART than among non-HIV-infected healthy controls (15.8 vs. 3.2%) [3]. A high incidence of diabetes mellitus (DM) and impaired fasting glucose (IFG) has been detected in HIV-infected patients receiving ART [4,5]. Another studies have found relationship between some classes of antiretroviral (ARV) drugs such as protease inhibitors (PIs) and nucleos(t)ide retrotranscriptase inhibitors (NRTIs) with a higher frequency of new-onset DM and IFG [6].Dyslipidemia is particularly frequent and is mostly characterized by hypertriglyceridemia and low HDL-cholesterol concentrations. AbstractBackground: People infected with human immunodeficiency virus (HIV) develop lipid and glucose metabolic alterations, which predisposes them to cardiovascular disease. The aim of this study was to evaluate the cumulative incidence of dyslipidemia and fasting glucose impairment after 48 weeks of initiating the first antiretroviral (ART) regimen and the association with the type of ART regimen.

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“…Furthermore, 20% of Chinese ART-naïve patients had elevated blood glucose levels, of whom 11% met the criteria for diabetes [ 32 ]. Other findings from China showed that diabetes and impaired fasting glucose developed relatively frequently in patients after they initiated ART (incidence of 2.62 and 35.64 per 100 person-years, respectively) [ 33 ]. Substantially, lower diabetes incidence rates were found in ART experienced patients in Thailand (5.0 per 1000 person-years) [ 34 ] and in high-income country Taiwan (13.1 per 1000 person-years) [ 35 ].…”

Section: Risk Factors Of Cardiovascular Diseasementioning

confidence: 99%

Cardiovascular Disease and Cardiovascular Disease Risk in HIV-Positive Populations in the Asian Region

Bijker¹,

Choi²,

Ditangco³

et al. 2017

TOAIDJ

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Introduction:Cardiovascular diseases (CVD) are becoming more prevalent in HIV-infected populations as they age largely due to improved treatment outcomes. Assessment of CVD risk and CVD risk factors in HIV-positive populations has focused on high income settings, while there are limited studies evaluating CVD in HIV-positive populations in the Asian region.Materials and Methods:We provided an overview of the prevalence and incidence of CVD and its risk factors in adult HIV-positive populations, and of the strategies currently in place for CVD management in the Asian region.Results:Studies from the Asian region showed that CVD and CVD risk factors, such as dyslipidaemia, elevated blood glucose, obesity and smoking, are highly prevalent in HIV-positive populations. A number of studies suggested that HIV infection and antiretroviral therapy may contribute to increased CVD risk. National HIV treatment guidelines provide some directions regarding CVD risk prevention and management in the HIV-infected population, however, they are limited in number and scope.Conclusion:Development and consolidation of guidelines for integrated CVD and HIV care are essential to control the burden of CVD in HIV-positive populations. To inform guidelines, policies and practice in the Asian region, research should focus on exploring appropriate CVD risk screening strategies and estimating current and future CVD mortality and morbidity rates.

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Multicenter Cohort Study of Diabetes Mellitus and Impaired Fasting Glucose in HIV-Infected Patients in China

Cited by 13 publications

References 63 publications

Diabetes, mortality and glucose monitoring rates in the TREAT Asia HIV Observational Database Low Intensity Transfer (TAHOD‐LITE) study

Diabetes, mortality and glucose monitoring rates in the TREAT Asia HIV Observational Database Low Intensity Transfer (TAHOD‐LITE) study

Dyslipidemia and Fasting Glucose Impairment among HIV-Infected Patients 48-Weeks after the First Antiretroviral Regimen

Cardiovascular Disease and Cardiovascular Disease Risk in HIV-Positive Populations in the Asian Region

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