Équipe épidémiologie clinique et médecine, université Antilles-Guyane, Pointe-à-Pitre, Guadeloupe, France.
Diabetes Metab. 2011 Apr;37(2):98-104. doi: 10.1016/j.diabet.2010.07.009. Epub 2010 Dec 3.
Insulin resistance and type 2 diabetes (T2D) are commonly seen in human immunodeficiency virus (HIV) infection and are related to antiretroviral therapy. Adiponectin and leptin secreted by adipocytes are both linked to body-fat distribution and insulin sensitivity. The present study aimed to assess the prevalence of insulin resistance and T2D, and their association with adiponectin and leptin, in Afro-Caribbean men and women with HIV infection.
This cross-sectional study was conducted in an unselected sample of 237 HIV-1-infected patients. Clinical and metabolic parameters were measured, including fasting and postload plasma insulin, and circulating adiponectin and leptin levels. Insulin resistance was estimated by homoeostasis model assessment (HOMA-IR). Adjusted multiple logistic regressions were used to estimate the association of insulin resistance with adipokine levels and patients' characteristics.
A total of 132 men (mean age: 49 years) and 105 women (mean age: 48 years) were included in the study. Prevalences of T2D and insulin resistance were higher in women than in men [16.2% vs 8.3% (P = 0.06) and 24% vs 9.9% (P < 10⁻³), respectively]. Abdominal obesity was found in 47% of women and in 7% of men (P < 10⁻⁴). Insulin resistance was independently associated with adiponectin in women and with leptin in men.
Insulin resistance is frequent in Afro-Caribbean women with HIV infection. Overweight and obesity are major risk factors in such a population. Systematic screening for insulin resistance should be carried out in this population, which has a high prevalence of T2D.
胰岛素抵抗和 2 型糖尿病（T2D）在人类免疫缺陷病毒（HIV）感染中较为常见，且与抗逆转录病毒治疗相关。脂肪细胞分泌的脂联素和瘦素均与体脂分布和胰岛素敏感性有关。本研究旨在评估 HIV 感染的非裔加勒比人群中胰岛素抵抗和 T2D 的流行情况，及其与脂联素和瘦素的关系。
这是一项横断面研究，纳入了未选择的 237 例 HIV-1 感染患者。测量了临床和代谢参数，包括空腹和负荷后血浆胰岛素以及循环脂联素和瘦素水平。通过稳态模型评估（HOMA-IR）来评估胰岛素抵抗情况。采用调整后的多因素逻辑回归来估计胰岛素抵抗与脂肪因子水平和患者特征的关系。
本研究共纳入 132 名男性（平均年龄：49 岁）和 105 名女性（平均年龄：48 岁）。女性 T2D 和胰岛素抵抗的患病率高于男性[16.2%比 8.3%（P = 0.06）和 24%比 9.9%（P < 10⁻³）]。女性中 47%存在腹型肥胖，而男性中仅为 7%（P < 10⁻⁴）。女性的胰岛素抵抗与脂联素独立相关，而男性则与瘦素独立相关。
HIV 感染的非裔加勒比女性中胰岛素抵抗较为常见。超重和肥胖是非裔加勒比人群的主要危险因素。在该人群中，应系统地筛查胰岛素抵抗，因为其 T2D 患病率较高。
