接受抗逆转录病毒治疗的HIV感染成人进展为糖尿病前期和糖尿病的发生率及驱动因素：一项全球系统评价和荟萃分析方案

Rates and drivers of progression to pre-diabetes and diabetes mellitus among HIV-infected adults on antiretroviral therapy: a global systematic review and meta-analysis protocol.

作者信息

Nansseu Jobert Richie N, Bigna Jean Joel R, Kaze Arnaud D, Noubiap Jean Jacques N

机构信息

Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon Sickle Cell Disease Unit, Mother and Child Center, Chantal Biya Foundation, Yaoundé, Cameroon.

Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon.

出版信息

BMJ Open. 2016 Sep 15;6(9):e012852. doi: 10.1136/bmjopen-2016-012852.

DOI:10.1136/bmjopen-2016-012852

PMID:27633645

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5030590/

Abstract

INTRODUCTION

With the new 'test and treat' policy of the WHO, it is obvious that the number of HIV-infected patients taking antiretroviral therapy (ART) will grow exponentially, with consequential increase in the burden of diabetes mellitus (DM). Our aim is to summarise existing data on the incidence of pre-diabetes and DM, and associated risk factors among HIV-infected adults.

METHODS AND ANALYSIS

This systematic review will include cohort studies reporting the incidence of pre-diabetes and/or DM, and associated risk factors among HIV-infected adults on ART, with these patients being free of any impaired glucose metabolism at study baseline. We will perform electronic searches in PubMed, Excerpta Medica Database (EMBASE), Web of Science and WHO Global Health Library, supplemented with manual searches. Articles published from 1 January 2000 to 31 July 2016, in English or French languages, and without any geographical restriction will be eligible for inclusion. 3 authors will independently screen, select studies, extract data and assess the risk of bias with discrepancies resolved by consensus. We will assess clinical heterogeneity by examining the study design and setting, criteria and cut-offs used to define pre-diabetes or DM, process of calculation of incidence and outcomes in each study. We will also assess statistical heterogeneity using the χ(2) test of homogeneity and quantify it using the I(2) statistic. A random effects meta-analysis will be used to estimate the overall cumulative incidence of pre-diabetes/DM and risk factors.

ETHICS AND DISSEMINATION

This systematic review will use data from published studies and does not require ethics approval. Its results are expected to help putting in place action plans and preventive measures to curb the growing burden of DM in the HIV population on ART. Findings will be published in a peer-reviewed journal and presented at scientific conferences.

PROSPERO REGISTRATION NUMBER

CRD42016039651.

摘要

引言

随着世界卫生组织新的“检测与治疗”政策的出台，显然接受抗逆转录病毒治疗（ART）的艾滋病毒感染患者数量将呈指数级增长，糖尿病（DM）负担也会相应增加。我们的目的是总结关于糖尿病前期和糖尿病发病率以及艾滋病毒感染成年人相关危险因素的现有数据。

方法与分析

本系统评价将纳入队列研究，这些研究报告接受ART治疗的艾滋病毒感染成年人中糖尿病前期和/或糖尿病的发病率以及相关危险因素，且这些患者在研究基线时无任何糖代谢受损情况。我们将在PubMed、医学文摘数据库（EMBASE）、科学网和世界卫生组织全球健康图书馆进行电子检索，并辅以手工检索。2000年1月1日至2016年7月31日期间发表的、语言为英语或法语且无任何地理限制的文章将符合纳入标准。3位作者将独立筛选、选择研究、提取数据并评估偏倚风险，如有分歧将通过协商解决。我们将通过检查研究设计与背景、用于定义糖尿病前期或糖尿病的标准与临界值、各研究中发病率和结局的计算过程来评估临床异质性。我们还将使用χ²同质性检验评估统计异质性，并使用I²统计量对其进行量化。将采用随机效应荟萃分析来估计糖尿病前期/糖尿病的总体累积发病率及危险因素。