Relationship of ethnicity and CD4 Count with glucose metabolism among HIV patients on Highly-Active Antiretroviral Therapy (HAART)

BMC Endocrine Disorders

Research Article

Dustin M Long¹  Dorothy E Lewis²  Ranjita Misra³  Steven E Riechman³  Henry J Pownall⁴  Prakash Chandra⁵  Rajagopal V Sekhar⁶  Ashok Balasubramanyam⁶  Ivonne Coraza⁷  Shivani Shinde⁸ 

[1] Department of Biostatistics, West Virginia University, Morgantown, USA;Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA;Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, USA;Section of Atherosclerosis and Lipoprotein Research, Baylor College of Medicine, Houston, TX, USA;Translational Metabolism Unit, Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA;Translational Metabolism Unit, Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA;Endocrine Service, Ben Taub General Hospital, Houston, TX, USA;Translational Metabolism Unit, Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA;Legacy Community Health Services, Houston, TX, USA;Translational Metabolism Unit, Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA;University of Texas School of Public Health, Houston, TX, USA;

关键词: African American;    Hispanic;    Impaired glucose tolerance;    HbA1c;    Dyslipidemia;   

DOI  :  10.1186/1472-6823-13-13

 received in 2012-08-22, accepted in 2013-03-18,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundHIV patients on HAART are prone to metabolic abnormalities, including insulin resistance, lipodystrophy and diabetes. This study purports to investigate the relationship of ethnicity and CD4+ T cell count attained after stable highly-active antiretroviral treatment (HAART) with glucose metabolism in hyperrtriglyceridemic HIV patients without a history of diabetes.MethodsDemographic, anthropometric, clinical, endocrinologic, energy expenditure and metabolic measures were obtained in 199 multiethnic, healthy but hypertriglyceridemic HIV-infected patients [46% Hispanic, 17% African-American, 37% Non-Hispanic White (NHW)] on stable HAART without a history of diabetes. The relationship of glucose and insulin responses to ethnicity, CD4 strata (low (<300/cc) or moderate-to-high (≥ 300/cc)), and their interaction was determined.ResultsAfrican-Americans had significantly greater impairment of glucose tolerance (P < 0.05) and HbA1c levels (P < .001) than either Hispanics or NHWs. In multivariate models, after adjusting for confounders (age, sex, HIV/HAART duration, smoking, obesity, glucose, insulin and lipids), African-Americans and Hispanics had significantly higher HbA1c and 2-hour glucose levels than NHW’s. Demonstrating a significant interaction between ethnicity and CD4 count (P = 0.023), African Americans with CD4 <300/cc and Hispanics with CD4 ≥300/cc had the most impaired glucose response following oral glucose challenge.ConclusionsAmong hypertriglyceridemic HIV patients on HAART, African-Americans and Hispanics are at increased risk of developing diabetes. Ethnicity also interacts with CD4+ T cell count attained on stable HAART to affect post-challenge glycemic response.

【 授权许可】

CC BY   
© Misra et al.; licensee BioMed Central Ltd. 2013