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成人接受高效抗逆转录病毒治疗与糖尿病及其相关因素的研究:系统评价和荟萃分析。

Diabetes mellitus among adults on highly active anti-retroviral therapy and its associated factors in Ethiopia: Systematic review and meta-analysis.

机构信息

Department of Pediatrics and Child Health Nursing; Collage of health Science, Debre Tabor University, Debre Tabor, Ethiopia.

Departement of Maternity and Neonatal Health Nursing; Collage of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

Diabetes Res Clin Pract. 2021 Dec;182:109125. doi: 10.1016/j.diabres.2021.109125. Epub 2021 Nov 4.

Abstract

BACKGROUND

Diabetes mellitus occurs as a comorbid illness among people living with HIV and, in particular those on Highly Active Anti-retroviral therapies (HAART). Previous studies have documented the prevalence of diabetes mellitus among adults on HAART; however, there is lack of comprehensive estimation. Hence, this study was aimed to estimate the pooled prevalence and associated factors of diabetes mellitus among adults on HAART in Ethiopia.

METHODS

Primary studies were exhaustively searched using Cochrane, PubMed, Google Scholar, Scopus and Web of science databases until February 2021. Eligible studies were selected and critically appraised for quality using the Joanna Briggs Institute (JBI) quality appraisal checklist. The required data were extracted and exported to Stata version 16 for meta-analysis. The overall prevalence of diabetes mellitus among adults on HAART was estimated using a weighted inverse random effect model. Sensitivity and sub-group analysis were conducted for evidence of heterogeneity. Trim and fill analysis was performed after Egger's test and funnel plot were indicating the presence of publication bias.

RESULTS

A total of 17 studies with 6,052 subjects on HAART were included. The pooled prevalence of diabetes mellitus among patients on HAART was 16.04% [95% Confidence Interval (CI); 11.6, 20.92]. Abnormal High Density Lipoprotein Cholesterol (HDL-C) [Adjusted Odd Ratio (AOR) = 4.68, 95% CI; 2.54, 6.82], Body Mass Index (BMI) ≥ 25 kg/m [AOR = 7.41, 95% CI; 2.75, 12.08], ≥6 years ART [AOR = 8.14, 95% CI; 5.85, 30.43], hypertension [AOR = 3.29, 95% CI; 2.13, 4.45], age 35-44 years [AOR = 6.28; 95% CI; 4.20, 8.37, BMI ≥ 30 kg/m [AOR = 7.81, 95% CI; 4.97, 10.64], educational status above diploma [AOR = 6.42, 95% CI; 1.28, 11.57] and age 45-55 years [AOR = 4.46, 95% CI; 2.81, 6.10] were positively associated with diabetes mellitus comorbidity among adults on HAART.

CONCLUSION

The higher prevalence of diabetes mellitus was observed for adults on HAART. HDL-C, duration of ART, hypertension, overweight, obesity, age and educational status of participants increases the prevalence of diabetes mellitus. The study highlights the importance of timely screening of HDL-C level, blood pressure and BMI for adults on HAART.

摘要

背景

糖尿病是艾滋病毒感染者的合并症之一,特别是在接受高效抗逆转录病毒疗法 (HAART) 的患者中。先前的研究已经记录了接受 HAART 的成年人中糖尿病的患病率;然而,缺乏全面的估计。因此,本研究旨在估计埃塞俄比亚接受 HAART 的成年人中糖尿病的 pooled 患病率和相关因素。

方法

使用 Cochrane、PubMed、Google Scholar、Scopus 和 Web of science 数据库全面搜索原始研究,直到 2021 年 2 月。选择符合条件的研究,并使用 Joanna Briggs 研究所 (JBI) 质量评估清单对其进行批判性评估。提取所需数据并导出到 Stata 版本 16 进行荟萃分析。使用加权逆随机效应模型估计接受 HAART 的成年人中糖尿病的总体患病率。进行敏感性和亚组分析以评估异质性证据。在 Egger 检验和漏斗图表明存在发表偏倚后,进行了修剪和填充分析。

结果

共有 17 项研究纳入了 6052 名接受 HAART 的患者。接受 HAART 的患者中糖尿病的 pooled 患病率为 16.04% [95%置信区间 (CI);11.6,20.92]。异常高密度脂蛋白胆固醇 (HDL-C) [调整后的优势比 (AOR) = 4.68,95%CI;2.54,6.82]、体重指数 (BMI) ≥ 25 kg/m [AOR = 7.41,95% CI;2.75,12.08]、≥6 年 ART [AOR = 8.14,95% CI;5.85,30.43]、高血压 [AOR = 3.29,95% CI;2.13,4.45]、35-44 岁年龄 [AOR = 6.28;95% CI;4.20,8.37]、BMI ≥ 30 kg/m [AOR = 7.81,95% CI;4.97,10.64]、高于文凭的教育程度 [AOR = 6.42,95% CI;1.28,11.57]和 45-55 岁年龄 [AOR = 4.46,95% CI;2.81,6.10]与接受 HAART 的成年人中糖尿病合并症呈正相关。

结论

接受 HAART 的成年人中糖尿病的患病率较高。HDL-C、ART 持续时间、高血压、超重、肥胖、年龄和参与者的教育程度增加了糖尿病的患病率。该研究强调了及时筛查 HDL-C 水平、血压和 BMI 的重要性。

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