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Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection
The prevalence of various comorbidities continue to rise in aging persons living with HIV-1 infection (PLWH), and our study here aimed to assess the rates and correlates of incident type 2 diabetes mellitus (T2DM) in PLWH from a retrospective, southeastern U.S. cohort. Based on electronic health rec...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719801/ https://www.ncbi.nlm.nih.gov/pubmed/33329379 http://dx.doi.org/10.3389/fendo.2020.555401 |
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author | Ye, Yuanfan Shrestha, Sadeep Burkholder, Greer Bansal, Anju Erdmann, Nathaniel Wiener, Howard Tang, Jianming |
author_facet | Ye, Yuanfan Shrestha, Sadeep Burkholder, Greer Bansal, Anju Erdmann, Nathaniel Wiener, Howard Tang, Jianming |
author_sort | Ye, Yuanfan |
collection | PubMed |
description | The prevalence of various comorbidities continue to rise in aging persons living with HIV-1 infection (PLWH), and our study here aimed to assess the rates and correlates of incident type 2 diabetes mellitus (T2DM) in PLWH from a retrospective, southeastern U.S. cohort. Based on electronic health records, we examined patient demographics, body mass index (BMI), HIV-1-related outcomes, hepatitis C virus co-infection, common comorbidities (e.g. shingles and asthma), usage of protease inhibitors, and usage of statins as potential correlates for T2DM occurrence. Among 3,975 PLWH with ≥12 months of follow-up between January 1999 and March 2018, the overall rate of incident T2DM was 135 per 10,000 person-years, almost 2-fold higher than the rate reported for the general U.S. population. In multivariable models (354 T2DM patients and 3,617 control subjects), sex, BMI, nadir CD4(+) T-cell count, HIV-1 viral load (VL) and duration of statin use were independent correlates of incident T2DM (adjusted P <0.05 for all), with clear consistency in several sensitivity analyses. The strongest associations (adjusted odds ratio/OR >2.0 and P <0.0001) were noted for: i) statin use for ≥6 months (OR = 10.2), ii) BMI ≥30 kg/m(2) (OR = 3.4), and iii) plasma VL ≥200 copies/ml (OR = 2.2). Their collective predictive value was substantial: the C-statistic for area under the receiver operating characteristics curve was 0.87 (95% CI = 0.84-0.91), showing close similarity between two major racial groups (C-statistic = 0.87 for African Americans and 0.91 for European Americans). Overall, these findings not only establish a promising algorithm for predicting incident T2DM in PLWH but also suggest that patients who are obese and use statins should require special consideration for T2DM diagnosis and prevention. |
format | Online Article Text |
id | pubmed-7719801 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77198012020-12-15 Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection Ye, Yuanfan Shrestha, Sadeep Burkholder, Greer Bansal, Anju Erdmann, Nathaniel Wiener, Howard Tang, Jianming Front Endocrinol (Lausanne) Endocrinology The prevalence of various comorbidities continue to rise in aging persons living with HIV-1 infection (PLWH), and our study here aimed to assess the rates and correlates of incident type 2 diabetes mellitus (T2DM) in PLWH from a retrospective, southeastern U.S. cohort. Based on electronic health records, we examined patient demographics, body mass index (BMI), HIV-1-related outcomes, hepatitis C virus co-infection, common comorbidities (e.g. shingles and asthma), usage of protease inhibitors, and usage of statins as potential correlates for T2DM occurrence. Among 3,975 PLWH with ≥12 months of follow-up between January 1999 and March 2018, the overall rate of incident T2DM was 135 per 10,000 person-years, almost 2-fold higher than the rate reported for the general U.S. population. In multivariable models (354 T2DM patients and 3,617 control subjects), sex, BMI, nadir CD4(+) T-cell count, HIV-1 viral load (VL) and duration of statin use were independent correlates of incident T2DM (adjusted P <0.05 for all), with clear consistency in several sensitivity analyses. The strongest associations (adjusted odds ratio/OR >2.0 and P <0.0001) were noted for: i) statin use for ≥6 months (OR = 10.2), ii) BMI ≥30 kg/m(2) (OR = 3.4), and iii) plasma VL ≥200 copies/ml (OR = 2.2). Their collective predictive value was substantial: the C-statistic for area under the receiver operating characteristics curve was 0.87 (95% CI = 0.84-0.91), showing close similarity between two major racial groups (C-statistic = 0.87 for African Americans and 0.91 for European Americans). Overall, these findings not only establish a promising algorithm for predicting incident T2DM in PLWH but also suggest that patients who are obese and use statins should require special consideration for T2DM diagnosis and prevention. Frontiers Media S.A. 2020-11-23 /pmc/articles/PMC7719801/ /pubmed/33329379 http://dx.doi.org/10.3389/fendo.2020.555401 Text en Copyright © 2020 Ye, Shrestha, Burkholder, Bansal, Erdmann, Wiener and Tang http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Ye, Yuanfan Shrestha, Sadeep Burkholder, Greer Bansal, Anju Erdmann, Nathaniel Wiener, Howard Tang, Jianming Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection |
title | Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection |
title_full | Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection |
title_fullStr | Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection |
title_full_unstemmed | Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection |
title_short | Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection |
title_sort | rates and correlates of incident type 2 diabetes mellitus among persons living with hiv-1 infection |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719801/ https://www.ncbi.nlm.nih.gov/pubmed/33329379 http://dx.doi.org/10.3389/fendo.2020.555401 |
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