Abstract
Objectives: To determine factors associated with diabetes, insulin resistance, and abnormal glucose tolerance in older men with or at risk of HIV infection. Methods: Diabetes was assessed by self-report in 643 men ≥ 49 years old with or at risk of HIV infection. In a subset of 216 men without previously diagnosed diabetes [including 90 HIV-uninfected men, 28 HIV-infected, antiretroviral-naive men, 28 HIV-infected men taking non-protease inhibitor (PI)-containing highly active antiretroviral therapy (HAART), and 70 HIV-infected men taking PI-containing HAART], an oral glucose tolerance test with insulin levels was performed. HIV serology, CD4 cell count, weight, height and waist circumference were measured. Antiretroviral use, drug use, family history of diabetes, physical activity and sociodemographic data were obtained using standardized interviews. Results: Of 643 participants, 116 (18%) had previously diagnosed diabetes. With the oral glucose tolerance test, 15 of 216 men (7%) were found to have undiagnosed diabetes and 40 (18%) impaired glucose tolerance. Factors independently associated with previously diagnosed diabetes included use of non-PI-containing HAART, methadone treatment, positive CAGE test for alcoholism, obesity and family history of diabetes. Factors independently associated with greater insulin resistance included waist circumference and heroin use. Factors independently associated with abnormal glucose tolerance (impaired glucose tolerance or diabetes) included age ≥ 55 years and Hispanic ethnicity. Conclusions: HIV-infected men with diabetes risk factors should undergo screening for diabetes regardless of HAART use. Interventions targeting modifiable risk factors, including overweight and physical inactivity, are warranted. The potential impact of opiate and alcohol abuse on glucose metabolism should be recognized in clinical care, and addressed in future research studies of HIV-infected persons.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 389-396 |
| Number of pages | 8 |
| Journal | HIV Medicine |
| Volume | 7 |
| Issue number | 6 |
| DOIs | |
| State | Published - Sep 2006 |
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Keywords
- Antiretroviral therapy
- Diabetes mellitus
- Insulin resistance
- Metabolic complications of HIV infection
- Opiate use
ASJC Scopus subject areas
- Virology
- Medicine(all)
- Immunology
Cite this
Abnormal glucose metabolism among older men with or at risk of HIV infection. / Howard, Andrea A.; Floris-Moore, M.; Lo, Yungtai; Arnsten, Julia H.; Fleischer, N.; Klein, R. S.
In: HIV Medicine, Vol. 7, No. 6, 09.2006, p. 389-396.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Abnormal glucose metabolism among older men with or at risk of HIV infection
AU - Howard, Andrea A.
AU - Floris-Moore, M.
AU - Lo, Yungtai
AU - Arnsten, Julia H.
AU - Fleischer, N.
AU - Klein, R. S.
PY - 2006/9
Y1 - 2006/9
N2 - Objectives: To determine factors associated with diabetes, insulin resistance, and abnormal glucose tolerance in older men with or at risk of HIV infection. Methods: Diabetes was assessed by self-report in 643 men ≥ 49 years old with or at risk of HIV infection. In a subset of 216 men without previously diagnosed diabetes [including 90 HIV-uninfected men, 28 HIV-infected, antiretroviral-naive men, 28 HIV-infected men taking non-protease inhibitor (PI)-containing highly active antiretroviral therapy (HAART), and 70 HIV-infected men taking PI-containing HAART], an oral glucose tolerance test with insulin levels was performed. HIV serology, CD4 cell count, weight, height and waist circumference were measured. Antiretroviral use, drug use, family history of diabetes, physical activity and sociodemographic data were obtained using standardized interviews. Results: Of 643 participants, 116 (18%) had previously diagnosed diabetes. With the oral glucose tolerance test, 15 of 216 men (7%) were found to have undiagnosed diabetes and 40 (18%) impaired glucose tolerance. Factors independently associated with previously diagnosed diabetes included use of non-PI-containing HAART, methadone treatment, positive CAGE test for alcoholism, obesity and family history of diabetes. Factors independently associated with greater insulin resistance included waist circumference and heroin use. Factors independently associated with abnormal glucose tolerance (impaired glucose tolerance or diabetes) included age ≥ 55 years and Hispanic ethnicity. Conclusions: HIV-infected men with diabetes risk factors should undergo screening for diabetes regardless of HAART use. Interventions targeting modifiable risk factors, including overweight and physical inactivity, are warranted. The potential impact of opiate and alcohol abuse on glucose metabolism should be recognized in clinical care, and addressed in future research studies of HIV-infected persons.
AB - Objectives: To determine factors associated with diabetes, insulin resistance, and abnormal glucose tolerance in older men with or at risk of HIV infection. Methods: Diabetes was assessed by self-report in 643 men ≥ 49 years old with or at risk of HIV infection. In a subset of 216 men without previously diagnosed diabetes [including 90 HIV-uninfected men, 28 HIV-infected, antiretroviral-naive men, 28 HIV-infected men taking non-protease inhibitor (PI)-containing highly active antiretroviral therapy (HAART), and 70 HIV-infected men taking PI-containing HAART], an oral glucose tolerance test with insulin levels was performed. HIV serology, CD4 cell count, weight, height and waist circumference were measured. Antiretroviral use, drug use, family history of diabetes, physical activity and sociodemographic data were obtained using standardized interviews. Results: Of 643 participants, 116 (18%) had previously diagnosed diabetes. With the oral glucose tolerance test, 15 of 216 men (7%) were found to have undiagnosed diabetes and 40 (18%) impaired glucose tolerance. Factors independently associated with previously diagnosed diabetes included use of non-PI-containing HAART, methadone treatment, positive CAGE test for alcoholism, obesity and family history of diabetes. Factors independently associated with greater insulin resistance included waist circumference and heroin use. Factors independently associated with abnormal glucose tolerance (impaired glucose tolerance or diabetes) included age ≥ 55 years and Hispanic ethnicity. Conclusions: HIV-infected men with diabetes risk factors should undergo screening for diabetes regardless of HAART use. Interventions targeting modifiable risk factors, including overweight and physical inactivity, are warranted. The potential impact of opiate and alcohol abuse on glucose metabolism should be recognized in clinical care, and addressed in future research studies of HIV-infected persons.
KW - Antiretroviral therapy
KW - Diabetes mellitus
KW - Insulin resistance
KW - Metabolic complications of HIV infection
KW - Opiate use
UR - http://www.scopus.com/inward/record.url?scp=33746410075&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33746410075&partnerID=8YFLogxK
U2 - 10.1111/j.1468-1293.2006.00398.x
DO - 10.1111/j.1468-1293.2006.00398.x
M3 - Article
C2 - 16903984
AN - SCOPUS:33746410075
VL - 7
SP - 389
EP - 396
JO - HIV Medicine
JF - HIV Medicine
SN - 1464-2662
IS - 6
ER -