Relationship of ethnicity and CD4 Count with glucose metabolism among HIV patients on Highly-Active Antiretroviral Therapy (HAART). Academic Article uri icon

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.

published proceedings

  • BMC Endocr Disord

altmetric score

  • 7.05

author list (cited authors)

  • Misra, R., Chandra, P., Riechman, S. E., Long, D. M., Shinde, S., Pownall, H. J., ... Balasubramanyam, A.

citation count

  • 8

complete list of 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

publication date

  • January 1, 2013 11:11 AM