Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.

<h4>Background</h4>Diabetes and insulin resistance is an emerging issue in people with HIV. HIV-related mortality and morbidities have decreased markedly over the last few decades, while co-morbidities including type 2 diabetes (T2D) have increased.<h4>Setting</h4>This study...

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Autores principales:	Göran Bratt, Johanna Brännström, Catharina Missalidis, Thomas Nyström
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5798a35a824a4ea59e3e52cfbcc1e296
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spelling	oai:doaj.org-article:5798a35a824a4ea59e3e52cfbcc1e2962021-12-02T20:15:43ZDevelopment of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.1932-620310.1371/journal.pone.0254079https://doaj.org/article/5798a35a824a4ea59e3e52cfbcc1e2962021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254079https://doaj.org/toc/1932-6203<h4>Background</h4>Diabetes and insulin resistance is an emerging issue in people with HIV. HIV-related mortality and morbidities have decreased markedly over the last few decades, while co-morbidities including type 2 diabetes (T2D) have increased.<h4>Setting</h4>This study investigated the incidence of T2D and insulin resistance in a cohort of HIV-patients on effective treatment.<h4>Methods</h4>Prevalence and baseline predictors of T2D were assessed in a cohort of 570 HIV-positive patients 50 years or older. Patients without diabetes (n = 505) were followed prospectively over a median period of 7.25 year (2012-2020) until T2D development, death or end of the study. T2D was defined as repeated fasting glucose values ≥7.0 mmol/L. Insulin resistance was defined as HOMA-IR ≥3.0. Predictors of T2D development (HIV-related parameters, lipids, hypertension, central obesity, inflammation, smoking and use of statins) were assessed using logistic regression analysis.<h4>Results</h4>30% (153/505) had insulin resistance. During follow up (3485 patient-years) 9% (43/505) developed T2D and 7% (36/505) insulin resistance. Thus, at follow up the prevalence of either T2D or insulin resistance was 46% (232/505). T2D incidence was 1.2/100 patient-years. In multivariate analysis, after adjustment for age, T2D development was associated with baseline insulin resistance, hypertriglyceridemia, central obesity and statin treatment, but no HIV-related factors.<h4>Conclusion</h4>The incidence of T2D in this cohort of patients with well controlled HIV-infection was high. The predictive factors associated with the development of T2D were not unique for HIV positive patients. The findings underline the importance of lifestyle changes in avoidance of T2D in people with HIV.Göran BrattJohanna BrännströmCatharina MissalidisThomas NyströmPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0254079 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Göran Bratt Johanna Brännström Catharina Missalidis Thomas Nyström Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.
description	<h4>Background</h4>Diabetes and insulin resistance is an emerging issue in people with HIV. HIV-related mortality and morbidities have decreased markedly over the last few decades, while co-morbidities including type 2 diabetes (T2D) have increased.<h4>Setting</h4>This study investigated the incidence of T2D and insulin resistance in a cohort of HIV-patients on effective treatment.<h4>Methods</h4>Prevalence and baseline predictors of T2D were assessed in a cohort of 570 HIV-positive patients 50 years or older. Patients without diabetes (n = 505) were followed prospectively over a median period of 7.25 year (2012-2020) until T2D development, death or end of the study. T2D was defined as repeated fasting glucose values ≥7.0 mmol/L. Insulin resistance was defined as HOMA-IR ≥3.0. Predictors of T2D development (HIV-related parameters, lipids, hypertension, central obesity, inflammation, smoking and use of statins) were assessed using logistic regression analysis.<h4>Results</h4>30% (153/505) had insulin resistance. During follow up (3485 patient-years) 9% (43/505) developed T2D and 7% (36/505) insulin resistance. Thus, at follow up the prevalence of either T2D or insulin resistance was 46% (232/505). T2D incidence was 1.2/100 patient-years. In multivariate analysis, after adjustment for age, T2D development was associated with baseline insulin resistance, hypertriglyceridemia, central obesity and statin treatment, but no HIV-related factors.<h4>Conclusion</h4>The incidence of T2D in this cohort of patients with well controlled HIV-infection was high. The predictive factors associated with the development of T2D were not unique for HIV positive patients. The findings underline the importance of lifestyle changes in avoidance of T2D in people with HIV.
format	article
author	Göran Bratt Johanna Brännström Catharina Missalidis Thomas Nyström
author_facet	Göran Bratt Johanna Brännström Catharina Missalidis Thomas Nyström
author_sort	Göran Bratt
title	Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.
title_short	Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.
title_full	Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.
title_fullStr	Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.
title_full_unstemmed	Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.
title_sort	development of type 2 diabetes and insulin resistance in people with hiv infection: prevalence, incidence and associated factors.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/5798a35a824a4ea59e3e52cfbcc1e296
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Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.

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