亚太地区艾滋病毒感染者中 BMI 与空腹血糖升高的相关性研究。

BMI as a predictor of high fasting blood glucose among people living with HIV in the Asia-Pacific region.

机构信息

Department of Epidemiology, University of California, Los Angeles, Los Angeles, California, USA.

Department of Public Health, University of Health Sciences, Phnom Penh, Cambodia.

出版信息

HIV Med. 2023 Feb;24(2):139-152. doi: 10.1111/hiv.13351. Epub 2022 Jun 24.

DOI:10.1111/hiv.13351

PMID:35748404

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9789206/

Abstract

BACKGROUND

Non-Asian body mass index (BMI) classifications are commonly used as a risk factor for high fasting blood glucose (FBG). We investigated the incidence and factors associated with high FBG among people living with HIV in the Asia-Pacific region, using a World Health Organization BMI classification specific to Asian populations.

METHODS

This study included people living with HIV enrolled in a longitudinal cohort study from 2003 to 2019, receiving antiretroviral therapy (ART), and without prior tuberculosis. BMI at ART initiation was categorized using Asian BMI classifications: underweight (<18.5 kg/m ), normal (18.5-22.9 kg/m ), overweight (23-24.9 kg/m ), and obese (≥25 kg/m ). High FBG was defined as a single post-ART FBG measurement ≥126 mg/dL. Factors associated with high FBG were analyzed using Cox regression models stratified by site.

RESULTS

A total of 3939 people living with HIV (63% male) were included. In total, 50% had a BMI in the normal weight range, 23% were underweight, 13% were overweight, and 14% were obese. Median age at ART initiation was 34 years (interquartile range 29-41). Overall, 8% had a high FBG, with an incidence rate of 1.14 per 100 person-years. Factors associated with an increased hazard of high FBG included being obese (≥25 kg/m ) compared with normal weight (hazard ratio [HR] = 1.79; 95% confidence interval [CI] 1.31-2.44; p < 0.001) and older age compared with those aged ≤30 years (31-40 years: HR = 1.47; 95% CI 1.08-2.01; 41-50 years: HR = 2.03; 95% CI 1.42-2.90; ≥51 years: HR = 3.19; 95% CI 2.17-4.69; p < 0.001).

CONCLUSION

People living with HIV with BMI >25 kg/m were at increased risk of high FBG. This indicates that regular assessments should be performed in those with high BMI, irrespective of the classification used.

摘要

背景

非亚洲体质指数（BMI）分类通常被用作空腹血糖高（FBG）的风险因素。我们使用特定于亚洲人群的世界卫生组织 BMI 分类，调查了亚太地区 HIV 感染者中 FBG 升高的发生率和相关因素。

方法

本研究纳入了 2003 年至 2019 年期间参加一项纵向队列研究、正在接受抗逆转录病毒治疗（ART）且无既往结核病的 HIV 感染者。ART 起始时的 BMI 采用亚洲 BMI 分类进行分类：体重不足（<18.5 kg/m ）、正常（18.5-22.9 kg/m ）、超重（23-24.9 kg/m ）和肥胖（≥25 kg/m ）。高 FBG 定义为单次 ART 后 FBG 测量值≥126 mg/dL。使用 Cox 回归模型对高 FBG 相关因素进行分析，按地点分层。

结果

共纳入 3939 名 HIV 感染者（63%为男性）。总体而言，50%的人 BMI 处于正常体重范围，23%体重不足，13%超重，14%肥胖。ART 起始时的中位年龄为 34 岁（四分位距 29-41）。总体而言，8%的人有高 FBG，发病率为每 100 人年 1.14 例。与正常体重者相比，肥胖（≥25 kg/m ）者高 FBG 的发生风险增加（风险比[HR]为 1.79；95%置信区间[CI]为 1.31-2.44；p<0.001），与年龄≤30 岁者相比，年龄 31-40 岁者（HR 为 1.47；95% CI 为 1.08-2.01；41-50 岁者：HR 为 2.03；95% CI 为 1.42-2.90；≥51 岁者：HR 为 3.19；95% CI 为 2.17-4.69；p<0.001）。