Johns Hopkins University, Baltimore, MD, USA.
Georgetown University Medical Center, Washington, DC, USA.
HIV Med. 2021 Jan;22(1):37-46. doi: 10.1111/hiv.12958. Epub 2020 Sep 24.
The aim of the study was to compare the prevalence of comorbid diabetes and depressive symptoms in men living with HIV (MLWH) with that in men without HIV infection and to determine associations between glycaemic control and depressive symptoms.
Participants included 920 MLWH and 840 men without HIV infection from the Multicenter AIDS Cohort Study (MACS) with available data regarding glycaemic status [categorized as normal for fasting blood glucose (FBG) < 100 mg/dL, prediabetes for FBG 100-125 mg/dL, and diabetes, defined by self-report, diabetes medication use or FBG ≥ 126 mg/dL on at least two consecutive visits, with diabetes classified as controlled if Hemoglobin A1c (HbA1C) < 7.5% and uncontrolled if HbA1C ≥ 7.5%]. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) score, with CES-D ≥ 16 scores classified as elevated depressive symptoms. A modified Poisson regression model with robust variance was used and adjusted for covariates including HIV serostatus.
Compared to men without HIV infection, MLWH had a higher mean CES-D score, but a similar prevalence of diabetes (11.3% versus 12.8%, respectively; P = 0.33). The concomitant prevalence of diabetes and elevated depressive symptoms did not differ by HIV serostatus (P = 0.215). In an adjusted analysis, men with uncontrolled diabetes had a greater prevalence of depressive symptoms compared to men with normoglycaemia (prevalence ratio = 1.43; 95% confidence interval 1.11, 1.84). The association between glycaemic status and depressive symptoms did not differ by HIV serostatus (P = 0.22 for interaction).
Both controlled and uncontrolled diabetes were independently associated with a greater prevalence of depressive symptoms, regardless of HIV serostatus. These results highlight the importance of identifying depression in people with diabetes.
本研究旨在比较合并糖尿病和抑郁症状的男性艾滋病病毒感染者（MLWH）与未感染 HIV 的男性的患病率，并确定血糖控制与抑郁症状之间的关联。
参与者包括来自多中心艾滋病队列研究（MACS）的 920 名 MLWH 和 840 名未感染 HIV 的男性，他们有血糖状况的数据[空腹血糖（FBG）<100mg/dL 为正常，100-125mg/dL 为糖尿病前期，自我报告、使用糖尿病药物或至少两次连续就诊时 FBG≥126mg/dL 为糖尿病，HbA1c（HbA1C）<7.5%为控制良好，HbA1C≥7.5%为控制不佳]。抑郁症状使用流行病学研究中心抑郁量表（CES-D）评分评估，CES-D≥16 分为抑郁症状升高。使用稳健方差的修正泊松回归模型进行调整，并调整了包括 HIV 血清状态在内的协变量。
与未感染 HIV 的男性相比，MLWH 的平均 CES-D 评分更高，但糖尿病的患病率相似（分别为 11.3%和 12.8%；P=0.33）。HIV 血清状态对糖尿病和抑郁症状同时发生的患病率没有影响（P=0.215）。在调整分析中，与血糖正常的男性相比，血糖控制不佳的男性抑郁症状的患病率更高（患病率比 1.43；95%置信区间 1.11，1.84）。血糖状况与抑郁症状之间的关联不受 HIV 血清状态的影响（交互作用 P=0.22）。
无论 HIV 血清状态如何，控制不佳和控制良好的糖尿病均与抑郁症状的更高患病率独立相关。这些结果强调了识别糖尿病患者抑郁症状的重要性。
