Abnormal glucose metabolism among older men with or at risk of HIV infection

Andrea A. Howard, M. Floris-Moore, Yungtai Lo, Julia H. Arnsten, N. Fleischer, R. S. Klein

Research output: Contribution to journalArticle

36 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)389-396
Number of pages8
JournalHIV Medicine
Volume7
Issue number6
DOIs
StatePublished - Sep 2006

Fingerprint

HIV Infections
Glucose
HIV
Highly Active Antiretroviral Therapy
Glucose Intolerance
Waist Circumference
Glucose Tolerance Test
Alcoholism
Insulin Resistance
Opiate Alkaloids
Methadone
Heroin
Serology
CD4 Lymphocyte Count
Protease Inhibitors
Hispanic Americans
Self Report
Obesity
Interviews
Exercise

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 journalArticle

Howard, Andrea A. ; Floris-Moore, M. ; Lo, Yungtai ; Arnsten, Julia H. ; Fleischer, N. ; Klein, R. S. / Abnormal glucose metabolism among older men with or at risk of HIV infection. In: HIV Medicine. 2006 ; Vol. 7, No. 6. pp. 389-396.
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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.",
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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.

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