Cargando…

Association Between Systemic Inflammation and Incident Diabetes in HIV-Infected Patients After Initiation of Antiretroviral Therapy

OBJECTIVE: To determine whether systemic inflammation after initiation of HIV-antiretroviral therapy (ART) is associated with the development of diabetes. RESEARCH DESIGN AND METHODS: We conducted a nested case-control study, comparing 55 previously ART-naive individuals who developed diabetes 48 we...

Descripción completa

Detalles Bibliográficos
Autores principales: Brown, Todd T., Tassiopoulos, Katherine, Bosch, Ronald J., Shikuma, Cecilia, McComsey, Grace A.
Formato: Texto
Lenguaje:English
Publicado: American Diabetes Association 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945167/
https://www.ncbi.nlm.nih.gov/pubmed/20664016
http://dx.doi.org/10.2337/dc10-0633
_version_ 1782187196929802240
author Brown, Todd T.
Tassiopoulos, Katherine
Bosch, Ronald J.
Shikuma, Cecilia
McComsey, Grace A.
author_facet Brown, Todd T.
Tassiopoulos, Katherine
Bosch, Ronald J.
Shikuma, Cecilia
McComsey, Grace A.
author_sort Brown, Todd T.
collection PubMed
description OBJECTIVE: To determine whether systemic inflammation after initiation of HIV-antiretroviral therapy (ART) is associated with the development of diabetes. RESEARCH DESIGN AND METHODS: We conducted a nested case-control study, comparing 55 previously ART-naive individuals who developed diabetes 48 weeks after ART initiation (case subjects) with 55 individuals who did not develop diabetes during a comparable follow-up (control subjects), matched on baseline BMI and race/ethnicity. Stored plasma samples at treatment initiation (week 0) and 1 year later (week 48) were assayed for levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and the soluble receptors of tumor necrosis factor-α (sTNFR1 and sTNFR2). RESULTS: Case subjects were older than control subjects (median age 41 vs. 37 years, P = 0.001), but the groups were otherwise comparable. Median levels for all markers, except hs-CRP, decreased from week 0 to week 48. Subjects with higher levels of hs-CRP, sTNFR1, and sTNFR2 at 48 weeks had an increased odds of subsequent diabetes, after adjustment for baseline marker level, age, BMI at week 48, CD4 count at week 48 (< vs. >200 cells/mm(3)), and indinavir use (all P(trend) ≤ 0.05). After further adjustment for week 48 glucose, effects were attenuated and only sTNFR1 remained significant (odds ratio, highest quartile vs. lowest 23.2 [95% CI 1.28–423], P = 0.03). CONCLUSIONS: Inflammatory markers 48 weeks after ART initiation were associated with increased risk of diabetes. These findings suggest that systemic inflammation may contribute to diabetes pathogenesis among HIV-infected patients.
format Text
id pubmed-2945167
institution National Center for Biotechnology Information
language English
publishDate 2010
publisher American Diabetes Association
record_format MEDLINE/PubMed
spelling pubmed-29451672011-10-01 Association Between Systemic Inflammation and Incident Diabetes in HIV-Infected Patients After Initiation of Antiretroviral Therapy Brown, Todd T. Tassiopoulos, Katherine Bosch, Ronald J. Shikuma, Cecilia McComsey, Grace A. Diabetes Care Original Research OBJECTIVE: To determine whether systemic inflammation after initiation of HIV-antiretroviral therapy (ART) is associated with the development of diabetes. RESEARCH DESIGN AND METHODS: We conducted a nested case-control study, comparing 55 previously ART-naive individuals who developed diabetes 48 weeks after ART initiation (case subjects) with 55 individuals who did not develop diabetes during a comparable follow-up (control subjects), matched on baseline BMI and race/ethnicity. Stored plasma samples at treatment initiation (week 0) and 1 year later (week 48) were assayed for levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and the soluble receptors of tumor necrosis factor-α (sTNFR1 and sTNFR2). RESULTS: Case subjects were older than control subjects (median age 41 vs. 37 years, P = 0.001), but the groups were otherwise comparable. Median levels for all markers, except hs-CRP, decreased from week 0 to week 48. Subjects with higher levels of hs-CRP, sTNFR1, and sTNFR2 at 48 weeks had an increased odds of subsequent diabetes, after adjustment for baseline marker level, age, BMI at week 48, CD4 count at week 48 (< vs. >200 cells/mm(3)), and indinavir use (all P(trend) ≤ 0.05). After further adjustment for week 48 glucose, effects were attenuated and only sTNFR1 remained significant (odds ratio, highest quartile vs. lowest 23.2 [95% CI 1.28–423], P = 0.03). CONCLUSIONS: Inflammatory markers 48 weeks after ART initiation were associated with increased risk of diabetes. These findings suggest that systemic inflammation may contribute to diabetes pathogenesis among HIV-infected patients. American Diabetes Association 2010-10 2010-07-27 /pmc/articles/PMC2945167/ /pubmed/20664016 http://dx.doi.org/10.2337/dc10-0633 Text en © 2010 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Brown, Todd T.
Tassiopoulos, Katherine
Bosch, Ronald J.
Shikuma, Cecilia
McComsey, Grace A.
Association Between Systemic Inflammation and Incident Diabetes in HIV-Infected Patients After Initiation of Antiretroviral Therapy
title Association Between Systemic Inflammation and Incident Diabetes in HIV-Infected Patients After Initiation of Antiretroviral Therapy
title_full Association Between Systemic Inflammation and Incident Diabetes in HIV-Infected Patients After Initiation of Antiretroviral Therapy
title_fullStr Association Between Systemic Inflammation and Incident Diabetes in HIV-Infected Patients After Initiation of Antiretroviral Therapy
title_full_unstemmed Association Between Systemic Inflammation and Incident Diabetes in HIV-Infected Patients After Initiation of Antiretroviral Therapy
title_short Association Between Systemic Inflammation and Incident Diabetes in HIV-Infected Patients After Initiation of Antiretroviral Therapy
title_sort association between systemic inflammation and incident diabetes in hiv-infected patients after initiation of antiretroviral therapy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945167/
https://www.ncbi.nlm.nih.gov/pubmed/20664016
http://dx.doi.org/10.2337/dc10-0633
work_keys_str_mv AT browntoddt associationbetweensystemicinflammationandincidentdiabetesinhivinfectedpatientsafterinitiationofantiretroviraltherapy
AT tassiopouloskatherine associationbetweensystemicinflammationandincidentdiabetesinhivinfectedpatientsafterinitiationofantiretroviraltherapy
AT boschronaldj associationbetweensystemicinflammationandincidentdiabetesinhivinfectedpatientsafterinitiationofantiretroviraltherapy
AT shikumacecilia associationbetweensystemicinflammationandincidentdiabetesinhivinfectedpatientsafterinitiationofantiretroviraltherapy
AT mccomseygracea associationbetweensystemicinflammationandincidentdiabetesinhivinfectedpatientsafterinitiationofantiretroviraltherapy