TY - JOUR
T1 - High prevalence of insulin resistance and occurrence prior to hyperinsulinemia threshold among people living with HIV in Pune, India
AU - Marbaniang, Ivan
AU - Sangle, Shashikala
AU - Salvi, Sonali
AU - Kulkarni, Vandana
AU - Shere, Dhananjay
AU - Deshpande, Prasad
AU - Nimkar, Smita
AU - Gupta, Amita
AU - Mave, Vidya
N1 - Funding Information:
This study was supported through a grant from TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the U.S. National Institutes of Health (NIH)'s National Institute of Allergy and Infectious Diseases , the Eunice Kennedy Shriver National Institute of Child Health and Human Development , the National Cancer Institute , the National Institute of Mental Health , and the National Institute on Drug Abuse , as part of the International Epidemiology Databases to Evaluate AIDS [IeDEA; U01AI069907 ] as well as the NIAID National Institutes of Health award number UM1AI069465 to AG. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the funders.
Publisher Copyright:
© 2019 Diabetes India
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Background: Diabetes prevalence in HIV is not well characterized for India, despite the high burden of both individual diseases. Epidemiology of insulin resistance (IR): a precursor to diabetes, and its associated risk factors are also poorly understood in Asian Indian people living with HIV (PLHIV). We assessed the prevalence of diabetes and IR in Pune, India and the associated risk factors for IR. Methods: Cross-sectional analysis of adult (≥18 years) PLHIV receiving care at Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India (BJGMC- SGH). Proportions and medians of PLHIV characteristics by diabetes status and IR were described. Homeostatic Model Assessment (HOMA) index value ≥2 was used to define IR. Line of least squares assessed the relationship between IR and hyperinsulinemia. Association between sociodemographic, clinical factors with IR was determined using logistic regression. Results: Of 485 enrollees, 47% were men, median age was 40 years (IQR: 35–46), median CD4 counts were 389 cells/mm3 (246–609). Thirty-five percent were centrally obese, 75% were adherent to WHO recommended physical activity guidelines. Prevalence of diabetes, prediabetes, IR were 9%, 16% and 38%, respectively. Twenty-nine percent non-diabetics had IR and it occurred much prior to the threshold for hyperinsulinemia. IR was associated with the use of ART drugs (OR: 6.6, 95% CI: 2.9–15.2 and 5.4, 95% CI: 2.2–13.6 for first- and second line ART respectively) and central obesity (OR:1.9, 95% CI: 1.1–3.4). Conclusions: One fourth of the study population was diabetic or prediabetic and more than a third had IR. Better understanding of diabetes disease progression in relation to IR and the effect of physical activity on central obesity among Asian Indian PLHIV is mandated.
AB - Background: Diabetes prevalence in HIV is not well characterized for India, despite the high burden of both individual diseases. Epidemiology of insulin resistance (IR): a precursor to diabetes, and its associated risk factors are also poorly understood in Asian Indian people living with HIV (PLHIV). We assessed the prevalence of diabetes and IR in Pune, India and the associated risk factors for IR. Methods: Cross-sectional analysis of adult (≥18 years) PLHIV receiving care at Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India (BJGMC- SGH). Proportions and medians of PLHIV characteristics by diabetes status and IR were described. Homeostatic Model Assessment (HOMA) index value ≥2 was used to define IR. Line of least squares assessed the relationship between IR and hyperinsulinemia. Association between sociodemographic, clinical factors with IR was determined using logistic regression. Results: Of 485 enrollees, 47% were men, median age was 40 years (IQR: 35–46), median CD4 counts were 389 cells/mm3 (246–609). Thirty-five percent were centrally obese, 75% were adherent to WHO recommended physical activity guidelines. Prevalence of diabetes, prediabetes, IR were 9%, 16% and 38%, respectively. Twenty-nine percent non-diabetics had IR and it occurred much prior to the threshold for hyperinsulinemia. IR was associated with the use of ART drugs (OR: 6.6, 95% CI: 2.9–15.2 and 5.4, 95% CI: 2.2–13.6 for first- and second line ART respectively) and central obesity (OR:1.9, 95% CI: 1.1–3.4). Conclusions: One fourth of the study population was diabetic or prediabetic and more than a third had IR. Better understanding of diabetes disease progression in relation to IR and the effect of physical activity on central obesity among Asian Indian PLHIV is mandated.
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U2 - 10.1016/j.dsx.2019.04.009
DO - 10.1016/j.dsx.2019.04.009
M3 - Article
C2 - 31235099
AN - SCOPUS:85064455973
SN - 1871-4021
VL - 13
SP - 1813
EP - 1819
JO - Diabetes and Metabolic Syndrome: Clinical Research and Reviews
JF - Diabetes and Metabolic Syndrome: Clinical Research and Reviews
IS - 3
ER -