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南非彼得马里茨堡埃登代尔医院感染人类免疫缺陷病毒且患有糖尿病的非洲黑人的电解质异常谱。

The spectrum of electrolyte abnormalities in black African people living with human immunodeficiency virus and diabetes mellitus at Edendale Hospital, Pietermaritzburg, South Africa.

作者信息

Pillay Preyanka, Pillay Somasundram, Mchunu Nobuhle

机构信息

Department of Internal Medicine, Greys Hospital, Pietermaritzburg, South Africa.

School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

出版信息

South Afr J HIV Med. 2020 Jul 23;21(1):1095. doi: 10.4102/sajhivmed.v21i1.1095. eCollection 2020.

Abstract

BACKGROUND

Serum electrolyte abnormalities in black African people living with human immunodeficiency virus (HIV) and diabetes mellitus (PLWH/DM) is unknown.

OBJECTIVES

The aim of this study was to analyse serum electrolytes (sodium, potassium, calcium and phosphate) and factors associated with electrolyte abnormalities in black African PLWH/DM versus HIV-uninfected patients with DM.

METHODS

We conducted a retrospective case-control study in 96 black African PLWH/DM (cases) and 192 HIV-uninfected patients with DM (controls), who were visiting the Edendale Hospital DM clinic, from 01 January 2016 to 31 December 2016. Pearson's correlation, multivariate linear and logistic regression analyses were utilised.

RESULTS

Hypocalcaemia was the most frequent electrolyte abnormality in PLWH/DM and HIV-uninfected patients with DM (31.25% vs. 22.91%), followed by hyponatraemia (18.75% vs. 13.54%). Median (IQR) corrected serum calcium levels were significantly lower in PLWH/DM compared with HIV-uninfected patients with DM (2.24 [2.18-2.30] mmol/L vs. 2.29 [2.20-2.36] mmol/L; = 0.001). For every per cent increase in glycated haemoglobin, the odds of hyponatraemia significantly increased in both PLWH/DM (odds ratio [OR]: 1.55; 95% confidence interval [CI]: 1.19 -2.02; = 0.003) and HIV-uninfected patients with DM (OR: 1.26; 95% CI: 1.04 -1.54; = 0.009).

CONCLUSION

Hypocalcaemia and hyponatraemia were the most frequent electrolyte abnormalities and occurred more frequently in PLWH/DM compared with HIV-uninfected patients with DM. People living with HIV and DM have significantly lower corrected serum calcium levels compared with HIV-uninfected patients with DM. Furthermore, hyponatraemia is a marker of impaired glycaemic control.

摘要

背景

感染人类免疫缺陷病毒(HIV)的非洲黑人糖尿病患者(PLWH/DM)的血清电解质异常情况尚不清楚。

目的

本研究旨在分析非洲黑人PLWH/DM与未感染HIV的糖尿病患者的血清电解质(钠、钾、钙和磷酸盐)及与电解质异常相关的因素。

方法

我们对2016年1月1日至2016年12月31日期间前往伊登代尔医院糖尿病门诊就诊的96例非洲黑人PLWH/DM(病例组)和192例未感染HIV的糖尿病患者(对照组)进行了一项回顾性病例对照研究。采用了Pearson相关性分析、多元线性回归分析和逻辑回归分析。

结果

低钙血症是PLWH/DM和未感染HIV的糖尿病患者中最常见的电解质异常(31.25%对22.91%),其次是低钠血症(18.75%对13.54%)。与未感染HIV的糖尿病患者相比,PLWH/DM的校正血清钙水平中位数(IQR)显著更低(2.24[2.18 - 2.30]mmol/L对2.29[2.20 - 2.36]mmol/L;P = 0.001)。糖化血红蛋白每增加1%,PLWH/DM(优势比[OR]:1.55;95%置信区间[CI]:1.19 - 2.02;P = 0.003)和未感染HIV的糖尿病患者(OR:1.26;95%CI:1.04 - 1.54;P = 0.009)发生低钠血症的几率均显著增加。

结论

低钙血症和低钠血症是最常见的电解质异常,与未感染HIV的糖尿病患者相比,PLWH/DM中更为常见。与未感染HIV的糖尿病患者相比,感染HIV的糖尿病患者校正血清钙水平显著更低。此外,低钠血症是血糖控制受损的一个指标。

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