Srivanich Nopporn, Ngarmukos Chardpraorn, Sungkanuparph Somnuek
Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Int Assoc Physicians AIDS Care (Chic). 2010 Nov-Dec;9(6):358-61. doi: 10.1177/1545109710373832. Epub 2010 Nov 12.
Pre-diabetes substantially increases the risk of developing macrovascular complication and progression to diabetes. This study aimed to determine the prevalence of and risk factors for pre-diabetes in HIV-1-infected patients. A cross-sectional study was conducted in HIV-1-infected patients who visited the infectious diseases clinic in a university hospital. Fasting plasma glucose (FPG) was performed. There were 149 patients, mean age 42.2 years, and 65.1% were males. Median CD4 count was 434 cells/mm(3). In total, 92% have received antiretroviral therapy (ART), with a median duration of 0.8 years. The prevalence of pre-diabetes was 27.5%. From multivariate analysis, body weight ([BW] per 5 kg increase, odds ratio [OR] = 1.241; 95% confidence interval [CI], 1.014-1.518; P = .036) and, tentatively, male gender (OR = 2.906; 95% CI, 0.941-8.976; P = .064) were risk factors for pre-diabetes. Nevirapine (NVP) use (OR = 0.383; 95% CI, 0.161-0.910; P = .030) was a protective factor for pre-diabetes. Pre-diabetes is common in HIV-1-infected patients receiving ART. Screening for pre-diabetes and active management should be performed in patients with risk factors.
糖尿病前期会大幅增加发生大血管并发症以及进展为糖尿病的风险。本研究旨在确定HIV-1感染患者中糖尿病前期的患病率及其危险因素。对一家大学医院传染病门诊的HIV-1感染患者进行了一项横断面研究。检测了空腹血糖（FPG）。共有149例患者，平均年龄42.2岁，男性占65.1%。CD4细胞计数中位数为434个/立方毫米。总体而言，92%的患者接受了抗逆转录病毒治疗（ART），治疗时间中位数为0.8年。糖尿病前期的患病率为27.5%。多因素分析显示，体重（每增加5千克，比值比[OR]=1.241；95%置信区间[CI]为1.014-1.518；P=0.036）以及初步分析显示男性性别（OR=2.906；95%CI为0.941-8.976；P=0.064）是糖尿病前期的危险因素。使用奈韦拉平（NVP）（OR=0.383；95%CI为0.161-0.910；P=0.030）是糖尿病前期的一个保护因素。糖尿病前期在接受ART的HIV-1感染患者中很常见。应对有危险因素的患者进行糖尿病前期筛查和积极管理。
