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HIV感染中的胰岛素抵抗与糖尿病

Insulin resistance and diabetes in HIV infection.

作者信息

Das Satyajit

机构信息

University of Warwick, Coventry Community Health Services, Stoney Stanton Road Coventry, CV1 4FH, UK.

出版信息

Recent Pat Antiinfect Drug Discov. 2011 Sep 1;6(3):260-8. doi: 10.2174/157489111796887846.

Abstract

Insulin resistance is an important and under recognized consequence of HIV treatment. Different studies have yielded widely varying estimates of the prevalence of impaired glucose metabolism in people on highly active antiretroviral therapy (HAART). The risk increases further with hepatitis C co infection. Although Protease inhibitors (PIs) are the main drug class implicated in insulin resistance, some studies have shown an association of increased risk of diabetes with cumulative exposure of nucleoside reverse transcriptase inhibitors (NRTIs). The effect of switching to other antiretrovirals has not been fully determined and the long-term consequences of insulin resistance in this population are not known. Treatment of established diabetes mellitus should generally follow existing guidelines. It is therefore reasonable to recommend general measures to increase insulin sensitivity in all patients infected with HIV, such as regular aerobic exercise and weight reduction for overweight persons. The present review article has the information of some recent patents regarding the insulin resistance in HIV infection.

摘要

胰岛素抵抗是HIV治疗的一个重要但未得到充分认识的后果。不同研究对接受高效抗逆转录病毒治疗(HAART)的人群中糖代谢受损的患病率给出了差异很大的估计。丙型肝炎合并感染会使风险进一步增加。虽然蛋白酶抑制剂(PIs)是与胰岛素抵抗相关的主要药物类别,但一些研究表明,糖尿病风险增加与核苷类逆转录酶抑制剂(NRTIs)的累积暴露有关。改用其他抗逆转录病毒药物的效果尚未完全确定,且该人群中胰岛素抵抗的长期后果尚不清楚。已确诊糖尿病的治疗通常应遵循现有指南。因此,建议对所有感染HIV的患者采取一般措施来提高胰岛素敏感性是合理的,比如定期进行有氧运动以及对超重者进行减重。本综述文章包含了一些近期关于HIV感染中胰岛素抵抗的专利信息。

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