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- Title
Relationship of ethnicity and CD4 Count with glucose metabolism among HIV patients on Highly-Active Antiretroviral Therapy (HAART).
- Authors
Misra, Ranjita; Chandra, Prakash; Riechman, Steven E.; Long, Dustin M.; Shinde, Shivani; Pownall, Henry J.; Coraza, Ivonne; Lewis, Dorothy E .; Sekhar, Rajagopal V.; Balasubramanyam, Ashok
- Abstract
Background: HIV patients on HAART are prone to metabolic abnormalities, including insulin resistance, lipodystrophy and diabetes. This study purports to investigate the relationship of ethnicity and CD4+ T cell count attained after stable highly-active antiretroviral treatment (HAART) with glucose metabolism in hyperrtriglyceridemic HIV patients without a history of diabetes. Methods: Demographic, anthropometric, clinical, endocrinologic, energy expenditure and metabolic measures were obtained in 199 multiethnic, healthy but hypertriglyceridemic HIV-infected patients [46% Hispanic, 17% African-American, 37% Non-Hispanic White (NHW)] on stable HAART without a history of diabetes. The relationship of glucose and insulin responses to ethnicity, CD4 strata (low (<300/cc) or moderate-to-high (≥ 300/cc)), and their interaction was determined. Results: African-Americans had significantly greater impairment of glucose tolerance (P < 0.05) and HbA1c levels (P < .001) than either Hispanics or NHWs. In multivariate models, after adjusting for confounders (age, sex, HIV/ HAART duration, smoking, obesity, glucose, insulin and lipids), African-Americans and Hispanics had significantly higher HbA1c and 2-hour glucose levels than NHW's. Demonstrating a significant interaction between ethnicity and CD4 count (P = 0.023), African Americans with CD4 <300/cc and Hispanics with CD4 ≥300/cc had the most impaired glucose response following oral glucose challenge. Conclusions: Among hypertriglyceridemic HIV patients on HAART, African-Americans and Hispanics are at increased risk of developing diabetes. Ethnicity also interacts with CD4+ T cell count attained on stable HAART to affect post-challenge glycemic response.
- Subjects
GLUCOSE metabolism; ANALYSIS of variance; BLACK people; BODY composition; CHI-squared test; ETHNIC groups; GLYCOSYLATED hemoglobin; HISPANIC Americans; HIV infections; HYPERLIPIDEMIA; PREDIABETIC state; STATISTICS; CD4 antigen; DATA analysis; HIGHLY active antiretroviral therapy; REPEATED measures design; DATA analysis software; DESCRIPTIVE statistics
- Publication
BMC Endocrine Disorders, 2013, Vol 13, Issue 1, p13
- ISSN
1472-6823
- Publication type
Article
- DOI
10.1186/1472-6823-13-13