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Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Research Article

Prevalence and Associated Risk Factors of Hyperglycemia and Diabetes Mellitus Among HIV Positive Patients in Tehran, Iran

Author(s): Mehrnaz Rasoolinejad, Ehsan Najafi, Azar Hadadi, Masood Najafi, Saeed Kalantari, Banafsheh Moradmand-Badie*, Katayoun Tayeri and SeyedAhmad SeyedAlinaghi*

Volume 19, Issue 3, 2019

Page: [304 - 309] Pages: 6

DOI: 10.2174/1871526518666180723152715

Price: $65

Abstract

Background: The introduction of Antiretroviral Therapy (ART) has resulted in the emergence of some metabolic complications including hyperglycemia and diabetes mellitus among HIV positive patients. The aim of this study was to investigate the prevalence of hyperglycemia, diabetes mellitus and their associated risk factors in HIV positive patients.

Methods: This cross-sectional study was conducted on HIV positive patients who visited Voluntary Counseling and Testing (VCT) center of Imam Khomeini Hospital, Tehran, Iran (2004-2013). Medical records of patients were reviewed retrospectively. A logistic regression model was applied for analysis of the association between glycemic status and relevant risk factors.

Results: Out of 480 patients who were included in this study, 267 (55.6%) had hyperglycemia, including 28 (5.8%) with diabetes mellitus and 239 (49.8%) with pre-diabetes. The higher frequency of hyperglycemia, was found to be significantly associated with older age (OR for patients ˃40 years old, 2.260; 95% CI, 1.491, 3.247), male gender (OR, 1.555; 95% CI, 1.047, 2.311), higher Body Mass Index (OR for patients with BMI˃25 Kg/m², 1.706; 95% CI, 1.149, 2.531) and prolonged duration of HIV infection (OR for patients with duration of HIV infection ≥60 months, 2.027; 95% CI, 1.372, 2.992).

Conclusion: Hyperglycemia, especially pre-diabetes, is highly frequent among Iranian people living with HIV. Male gender, older age, prolonged duration of HIV infection, and higher BMI were associated with a higher prevalence of hyperglycemia. Hence, it is important to screen all HIV infected patients at the time of diagnosis and then periodically for hyperglycemia.

Keywords: HIV, antiretroviral therapy, diabetes mellitus, hyperglycemia, prevalence, risk factors.

Graphical Abstract
[1]
Ryan, J.G. Increased risk for type 2 diabetes mellitus with HIV-1 infection. Insulin, 2010, 5, 37-45.
[http://dx.doi.org/10.1016/S1557-0843(10)80008-9]
[2]
Idiculla, J.; Ravindra’n, G.D.; D’Souza, J.; Singh, G.; Furruqh, S. Diabetes mellitus, insulin resistance, and metabolic syndrome in HIV-positive patients in South India. Int. J. Gen. Med., 2011, 4, 73-78.
[http://dx.doi.org/10.2147/IJGM.S15818] [PMID: 21403795]
[3]
Wu, P-Y.; Hung, C-C.; Liu, W-C.; Hsieh, C.Y.; Sun, H.Y.; Lu, C.L.; Wu, H.; Chien, K.L. Metabolic syndrome among HIV-infected Taiwanese patients in the era of highly active antiretroviral therapy: prevalence and associated factors. J. Antimicrob. Chemother., 2012, 67(4), 1001-1009.
[http://dx.doi.org/10.1093/jac/dkr558] [PMID: 22232517]
[4]
Mandina Ndona, M.; Longo-Mbenza, B.; Wumba, R.; Tandu Umba, B.; Buassa-Bu-Tsumbu, B.; Mbula Mambimbi, M.; Wobin, T.O.; Mbungu Fuele, S. Nadir CD4+, religion, antiretroviral therapy, incidence of type 2 diabetes mellitus, and increasing rates of obesity among black Africans with HIV disease. Int. J. Gen. Med., 2012, 5, 983-990.
[PMID: 23226071]
[5]
Mittal, A.; Achappa, B.; Madi, D.; Chowta, M.N.; Ramapuram, J.T.; Rao, S.; Unnikrishnan, B.; Mahalingam, S. The development of metabolic risk factors after the initiation of the second line anti- retroviral therapy. J. Clin. Diagn. Res., 2013, 7(2), 265-268.
[http://dx.doi.org/10.7860/JCDR/2013/4740.2743] [PMID: 23542168]
[6]
Shen, Y.; Wang, Z.; Liu, L.; Zhang, R.; Zheng, Y.; Lu, H. Prevalence of hyperglycemia among adults with newly diagnosed HIV/AIDS in China. BMC Infect. Dis., 2013, 13, 79.
[http://dx.doi.org/10.1186/1471-2334-13-79] [PMID: 23394285]
[7]
Worm, S.W.; De Wit, S.; Weber, R.; Sabin, C.A.; Reiss, P.; El-Sadr, W.; Monforte, A.D.; Kirk, O.; Fontas, E.; Dabis, F.; Law, M.G.; Lundgren, J.D.; Friis-Møller, N. Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study). Circulation, 2009, 119(6), 805-811.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.108.790857] [PMID: 19188509]
[8]
Pullinger, C.R.; Aouizerat, B.E.; Gay, C.; Coggins, T.; Movsesyan, I.; Davis, H.; Kane, J.P.; Portillo, C.; Lee, K.A. Metabolic abnormalities and coronary heart disease risk in human immunodeficiency virus-infected adults. Metab. Syndr. Relat. Disord., 2010, 8(3), 279-286.
[http://dx.doi.org/10.1089/met.2009.0094] [PMID: 20235745]
[9]
Abebe, M.; Kinde, S.; Belay, G.; Gebreegziabxier, A.; Challa, F.; Gebeyehu, T.; Nigussie, P.; Tegbaru, B. Antiretroviral treatment associated hyperglycemia and dyslipidemia among HIV infected patients at Burayu Health Center, Addis Ababa, Ethiopia: a cross-sectional comparative study. BMC Res. Notes, 2014, 7, 380.
[http://dx.doi.org/10.1186/1756-0500-7-380] [PMID: 24950924]
[10]
Yoon, C.; Gulick, R.M.; Hoover, D.R.; Vaamonde, C.M.; Glesby, M.J. Case-control study of diabetes mellitus in HIV-infected patients. J. Acquir. Immune Defic. Syndr., 2004, 37(4), 1464-1469.
[http://dx.doi.org/10.1097/01.qai.0000137373.26438.18] [PMID: 15602124]
[11]
Brown, T.T.; Cole, S.R.; Li, X.; Kingsley, L.A.; Palella, F.J.; Riddler, S.A.; Visscher, B.R.; Margolick, J.B.; Dobs, A.S. Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the multicenter AIDS cohort study. Arch. Intern. Med., 2005, 165(10), 1179-1184.
[http://dx.doi.org/10.1001/archinte.165.10.1179] [PMID: 15911733]
[12]
Association, A.D. Diagnosis and classification of diabetes mellitus. Diabetes Care, 2010, 33(Suppl. 1), S62-S69.
[http://dx.doi.org/10.2337/dc10-S062] [PMID: 20042775]
[13]
Esteghamati, A.; Gouya, M.M.; Abbasi, M.; Delavari, A.; Alikhani, S.; Alaedini, F.; Safaie, A.; Forouzanfar, M.; Gregg, E.W. Prevalence of diabetes and impaired fasting glucose in the adult population of Iran: National Survey of Risk Factors for Non-Communicable Diseases of Iran. Diabetes Care, 2008, 31(1), 96-98.
[http://dx.doi.org/10.2337/dc07-0959] [PMID: 17921357]
[14]
Grunfeld, C. Insulin resistance in HIV infection: drugs, host responses, or restoration to health? Topics in HIV medicine: a publication of the International AIDS Society, USA., 2007, 16, 89-93.
[15]
Butt, A.A.; McGinnis, K.; Rodriguez-Barradas, M.C.; Crystal, S.; Simberkoff, M.; Goetz, M.B.; Leaf, D.; Justice, A.C. HIV infection and the risk of diabetes mellitus. AIDS, 2009, 23(10), 1227-1234.
[http://dx.doi.org/10.1097/QAD.0b013e32832bd7af] [PMID: 19444074]
[16]
Gutierrez, A.D.; Balasubramanyam, A. Dysregulation of glucose metabolism in HIV patients: epidemiology, mechanisms, and management. Endocrine, 2012, 41(1), 1-10.
[http://dx.doi.org/10.1007/s12020-011-9565-z] [PMID: 22134974]
[17]
Brown, T.T.; Tassiopoulos, K.; Bosch, R.J.; Shikuma, C.; McComsey, G.A. Association between systemic inflammation and incident diabetes in HIV-infected patients after initiation of antiretroviral therapy. Diabetes Care, 2010, 33(10), 2244-2249.
[http://dx.doi.org/10.2337/dc10-0633] [PMID: 20664016]
[18]
Ledergerber, B.; Furrer, H.; Rickenbach, M.; Lehmann, R.; Elzi, L.; Hirschel, B.; Cavassini, M.; Bernasconi, E.; Schmid, P.; Egger, M.; Weber, R. Factors associated with the incidence of type 2 diabetes mellitus in HIV-infected participants in the Swiss HIV Cohort Study. Clin. Infect. Dis., 2007, 45(1), 111-119.
[http://dx.doi.org/10.1086/518619] [PMID: 17554711]
[19]
De Wit, S.; Sabin, C.A.; Weber, R.; Worm, S.W.; Reiss, P.; Cazanave, C.; El-Sadr, W.; Monforte, Ad.; Fontas, E.; Law, M.G.; Friis-Møller, N.; Phillips, A. Incidence and risk factors for new-onset diabetes in HIV-infected patients: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Diabetes Care, 2008, 31(6), 1224-1229.
[http://dx.doi.org/10.2337/dc07-2013] [PMID: 18268071]
[20]
Florescu, D.; Kotler, D.P. Insulin resistance, glucose intolerance and diabetes mellitus in HIV-infected patients. Antivir. Ther. (Lond.), 2007, 12(2), 149-162.
[PMID: 17503657]
[21]
Howard, A.A.; Hoover, D.R.; Anastos, K. The effects of opiate use and hepatitis C virus infection on risk of diabetes mellitus in the Women’s Interagency HIV Study. J. Acquir. Immune Defic. Syndr., 1999, 2010(54), 152.
[22]
Mofid, A.; Seyedalinaghi, S.A.; Zandieh, S. Prevalence and Risk Factors of Erectile Dysfunction in Iranian Diabetic Men. Acta Med. Iran., 2009, 47, 309-314.

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