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糖尿病患者在接受护理的大量艾滋病毒感染者中的控制情况-华盛顿特区。

Diabetes mellitus control in a large cohort of people with HIV in care-Washington, D.C.

机构信息

Department of Epidemiology, Milken Institute School of Public Health at the George Washington University, Washington, DC, USA.

Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA.

出版信息

AIDS Care. 2021 Nov;33(11):1464-1474. doi: 10.1080/09540121.2020.1808160. Epub 2020 Aug 18.

Abstract

With more effective antiretroviral therapy (ART), people with HIV (PWH) are living longer and have more chronic diseases, including diabetes mellitus (DM). The prevalence of DM has been estimated in PWH previously, however there is less research regarding DM control. Our objectives were to determine the prevalence of DM and DM control and determine factors associated with DM control in a large urban cohort of PWH in care. We examined DC Cohort participants aged ≥18 years old to determine DM prevalence and to assess DM control (HbA1c measurement <7.0%). Demographic, clinical, and HIV-related factors associated with DM control were identified using multivariate logistic regression. The cohort of 5876 participants was predominantly male (71.3%), Non-Hispanic Black (78.1%) and had a median age of 52.0 years. DM prevalence was 17.4% (1023/5876). Among participants with recent HbA1c data available (39.9%) the proportion with DM control was 60.0% (245/408). In multivariate analysis, higher BMI (aOR: 0.47; 95% CI 0.28, 0.79) and use of non-insulin DM medication (aOR 0.43, 95% CI 0.25, 0.73) or insulin (aOR 0.010, 95% CI 0.04,0.24) compared to no medication use. Our findings suggest that individuals on medication for their DM likely need enhanced support to reach their treatment goals.

摘要

随着更有效的抗逆转录病毒疗法(ART)的出现,艾滋病毒感染者(PWH)的寿命延长,同时也患有更多的慢性病,包括糖尿病(DM)。之前已经对 PWH 中的 DM 患病率进行了估计,但关于 DM 控制的研究较少。我们的目标是确定在接受治疗的大量城市 PWH 队列中 DM 的患病率和 DM 控制情况,并确定与 DM 控制相关的因素。我们检查了 DC 队列参与者,年龄≥18 岁,以确定 DM 的患病率,并评估 DM 控制(HbA1c 测量值<7.0%)。使用多变量逻辑回归确定与 DM 控制相关的人口统计学、临床和 HIV 相关因素。该队列共 5876 名参与者,主要为男性(71.3%),非西班牙裔黑人(78.1%),中位年龄为 52.0 岁。DM 的患病率为 17.4%(1023/5876)。在有最近 HbA1c 数据可查的参与者中(39.9%),DM 控制率为 60.0%(245/408)。在多变量分析中,较高的 BMI(调整后的比值比:0.47;95%可信区间 0.28,0.79)以及使用非胰岛素 DM 药物(调整后的比值比:0.43,95%可信区间 0.25,0.73)或胰岛素(调整后的比值比:0.010,95%可信区间 0.04,0.24)与未使用药物相比。我们的研究结果表明,接受 DM 药物治疗的个体可能需要加强支持以实现其治疗目标。

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