Glycated haemoglobin in diabetic women with and without HIV infection

Data from the Women's Interagency HIV Study

Marshall J. Glesby, Donald R. Hoover, Qiuhu Shi, Ann Danoff, Andrea Howard, Phyllis Tien, Dan Merenstein, Mardge Cohen, Elizabeth Golub, Jack DeHovitz, Marek Nowicki, Kathryn Anastos

Research output: Contribution to journalArticle

Abstract

Background: Limited data suggest that glycated haemoglobin (haemoglobin A1c; A1C) values might not reflect glycaemic control accurately in HIV-infected individuals with diabetes. Methods: We evaluated repeated measures of paired fasting glucose and A1C values in 315 HIV-infected and 109 HIV-uninfected diabetic participants in the Women's Interagency HIV Study. Generalized estimating equations used log A1C as the outcome variable, with adjustment for log fasting glucose concentration in all models. Results: An HIV-infected woman on average had 0.9868 times as much A1C (that is, 1.32% lower; 95% confidence interval 0.9734-0.9904) as an HIV-uninfected woman with the same log fasting glucose concentration. In multivariate analyses, HIV serostatus was not associated, but White, other non-Black race, and higher red blood cell mean corpuscular volume (MCV) were statistically associated with lower A1C values. Use of diabetic medication was associated with higher A1C values. In multivariate analyses restricted to HIV-infected women, White and other race, higher MCV, and HCV viraemia were associated with lower A1C values, whereas older age, use of diabetic medications and higher CD4+ T-cell count were associated with higher A1C values. Use of combination antiretroviral therapy, protease inhibitors, zidovudine, stavudine or abacavir was not associated with A1C values. Conclusions: A1C values were modestly lower in HIV-infected diabetic women relative to HIV-uninfected diabetic women after adjustment for fasting glucose concentration. The difference was abrogated by adjustment for MCV, race and diabetic medication use. Our data suggest that in clinical practice A1C gives a reasonably accurate refection of glycaemic control in HIV-infected diabetic women.

Original languageEnglish (US)
Pages (from-to)571-577
Number of pages7
JournalAntiviral Therapy
Volume15
Issue number4
DOIs
StatePublished - 2010

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Glycosylated Hemoglobin A
HIV Infections
HIV
Erythrocyte Indices
Fasting
Glucose
Multivariate Analysis
Stavudine
Zidovudine
Viremia
CD4 Lymphocyte Count
Protease Inhibitors
Hemoglobins
Erythrocytes
Confidence Intervals
T-Lymphocytes

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases
  • Medicine(all)

Cite this

Glesby, M. J., Hoover, D. R., Shi, Q., Danoff, A., Howard, A., Tien, P., ... Anastos, K. (2010). Glycated haemoglobin in diabetic women with and without HIV infection: Data from the Women's Interagency HIV Study. Antiviral Therapy, 15(4), 571-577. https://doi.org/10.3851/IMP1557

Glycated haemoglobin in diabetic women with and without HIV infection : Data from the Women's Interagency HIV Study. / Glesby, Marshall J.; Hoover, Donald R.; Shi, Qiuhu; Danoff, Ann; Howard, Andrea; Tien, Phyllis; Merenstein, Dan; Cohen, Mardge; Golub, Elizabeth; DeHovitz, Jack; Nowicki, Marek; Anastos, Kathryn.

In: Antiviral Therapy, Vol. 15, No. 4, 2010, p. 571-577.

Research output: Contribution to journalArticle

Glesby, MJ, Hoover, DR, Shi, Q, Danoff, A, Howard, A, Tien, P, Merenstein, D, Cohen, M, Golub, E, DeHovitz, J, Nowicki, M & Anastos, K 2010, 'Glycated haemoglobin in diabetic women with and without HIV infection: Data from the Women's Interagency HIV Study', Antiviral Therapy, vol. 15, no. 4, pp. 571-577. https://doi.org/10.3851/IMP1557
Glesby, Marshall J. ; Hoover, Donald R. ; Shi, Qiuhu ; Danoff, Ann ; Howard, Andrea ; Tien, Phyllis ; Merenstein, Dan ; Cohen, Mardge ; Golub, Elizabeth ; DeHovitz, Jack ; Nowicki, Marek ; Anastos, Kathryn. / Glycated haemoglobin in diabetic women with and without HIV infection : Data from the Women's Interagency HIV Study. In: Antiviral Therapy. 2010 ; Vol. 15, No. 4. pp. 571-577.
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AU - Danoff, Ann

AU - Howard, Andrea

AU - Tien, Phyllis

AU - Merenstein, Dan

AU - Cohen, Mardge

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AU - Nowicki, Marek

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N2 - Background: Limited data suggest that glycated haemoglobin (haemoglobin A1c; A1C) values might not reflect glycaemic control accurately in HIV-infected individuals with diabetes. Methods: We evaluated repeated measures of paired fasting glucose and A1C values in 315 HIV-infected and 109 HIV-uninfected diabetic participants in the Women's Interagency HIV Study. Generalized estimating equations used log A1C as the outcome variable, with adjustment for log fasting glucose concentration in all models. Results: An HIV-infected woman on average had 0.9868 times as much A1C (that is, 1.32% lower; 95% confidence interval 0.9734-0.9904) as an HIV-uninfected woman with the same log fasting glucose concentration. In multivariate analyses, HIV serostatus was not associated, but White, other non-Black race, and higher red blood cell mean corpuscular volume (MCV) were statistically associated with lower A1C values. Use of diabetic medication was associated with higher A1C values. In multivariate analyses restricted to HIV-infected women, White and other race, higher MCV, and HCV viraemia were associated with lower A1C values, whereas older age, use of diabetic medications and higher CD4+ T-cell count were associated with higher A1C values. Use of combination antiretroviral therapy, protease inhibitors, zidovudine, stavudine or abacavir was not associated with A1C values. Conclusions: A1C values were modestly lower in HIV-infected diabetic women relative to HIV-uninfected diabetic women after adjustment for fasting glucose concentration. The difference was abrogated by adjustment for MCV, race and diabetic medication use. Our data suggest that in clinical practice A1C gives a reasonably accurate refection of glycaemic control in HIV-infected diabetic women.

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