Infectious Diseases Unit Hôtel-Dieu Hospital, APHP centre, Université de Paris, Paris, France.
Feinberg School of Medicine, Northwestern University, Chicago, IL.
AIDS. 2021 Aug 1;35(10):1605-1614. doi: 10.1097/QAD.0000000000002922.
Diabetes mellitus is a major comorbidity in people with HIV (PWH). Hyperglycemia below diabetic range defines prediabetes (prediabetes mellitus). We compared the progression from prediabetes mellitus to diabetes mellitus in PWH and people without HIV (PWOH).
Fasting glucose was measured semiannually in the MACS since 1999. Men with prediabetes mellitus (fasting glucose between 100 and 125 mg/dl, confirmed within a year by fasting glucose in the prediabetes mellitus range or HbA1c between 5.7 and 6.4%) were included. The first visit with prediabetes mellitus was the baseline visit. Incident diabetes mellitus was defined as fasting glucose at least 126 mg/dl, confirmed at a subsequent visit, or self-reported diabetes mellitus, or use of anti-diabetes mellitus medication. We used binomial transition models to compare the progression from prediabetes mellitus to diabetes mellitus by HIV serostatus, adjusted for age, number of previous prediabetes mellitus to diabetes mellitus transitions, ethnicity, BMI, family history of diabetes mellitus, and hepatitis C virus (HCV) infection.
Between 1999 and 2019, 1584 men (793 PWH; 791 PWOH) with prediabetes mellitus were included. At baseline, PWH were younger (48 vs. 51 years, P < 0.01), had lower BMI (26 vs. 27), were more frequently nonwhite (47 vs. 30%), and HCV-infected as per last measure (8 vs. 4%) than PWOH (all P < 0.01). Over a median 12-year follow-up, 23% of participants developed diabetes mellitus. In adjusted analyses, the risk for incident diabetes mellitus was 40% (95% CI: 0--80%) higher among PWH than PWOH (P = 0.04).
Among men with prediabetes mellitus, PWH had an increased risk of incident diabetes mellitus adjusted for competing risk factors, warranting the evaluation of diabetes mellitus prevention strategies.
糖尿病是艾滋病毒感染者（PWH）的主要合并症。低于糖尿病范围的高血糖定义为糖尿病前期（糖尿病前期）。我们比较了 PWH 和无艾滋病毒感染者（PWOH）从糖尿病前期发展为糖尿病的情况。
自 1999 年以来，MACS 每半年测量一次空腹血糖。患有糖尿病前期（空腹血糖在 100 至 125mg/dl 之间，一年内通过空腹血糖在糖尿病前期范围内或 HbA1c 在 5.7 至 6.4%之间确认）的男性被纳入研究。首次出现糖尿病前期的就诊被定义为基线就诊。新发糖尿病定义为空腹血糖至少 126mg/dl，在随后的就诊中得到确认，或自我报告患有糖尿病，或使用抗糖尿病药物。我们使用二项式转移模型比较了根据 HIV 血清状况从糖尿病前期发展为糖尿病的情况，调整了年龄、糖尿病前期到糖尿病的转变次数、种族、BMI、糖尿病家族史和丙型肝炎病毒（HCV）感染等因素。
在 1999 年至 2019 年间，共纳入 1584 名患有糖尿病前期的男性（793 名 PWH；791 名 PWOH）。在基线时，PWH 更年轻（48 岁 vs. 51 岁，P<0.01），BMI 较低（26 岁 vs. 27 岁），非白人比例较高（47% vs. 30%），且根据最近一次检测结果，HCV 感染率较高（8% vs. 4%）（均 P<0.01）。在中位 12 年的随访期间，23%的参与者发生了糖尿病。在调整后的分析中，PWH 发生新发糖尿病的风险比 PWOH 高 40%（95%CI：0--80%）（P=0.04）。
在患有糖尿病前期的男性中，PWH 发生新发糖尿病的风险在调整了竞争风险因素后有所增加，需要评估糖尿病预防策略。
