Magodoro I M, Castle A C, Tshuma N, Goedecke J H, Sewpaul R, Manasa J, Manne-Goehler J, Ntusi Nab, Nyirenda M J, Siedner M J
medRxiv. 2024 Mar 14:2024.03.10.24304033. doi: 10.1101/2024.03.10.24304033.
It is unclear how rising obesity among people with HIV (PWH) in sub-Saharan Africa (SSA) impacts their risk of type 2 diabetes mellitus (diabetes). Using a South African national cross-sectional sample of adult PWH and their peers without HIV (PWOH), we examined the associations between HIV and prevalent diabetes across the spectrum of body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WtHR). Analyses were sex stratified, and adjusted for age, sociodemographic and behavioral factors. The prevalence of diabetes among males was similar between PWH and PWOH, overall and at all levels of adiposity. In contrast, overall diabetes prevalence was higher among female PWOH than female PWH. However, there were differences according to adiposity such that, compared to female PWOH, relative diabetes prevalence in female PWH was reduced with obesity but accentuated with leanness. These differences in the relationship between adiposity and diabetes by HIV serostatus call for better mechanistic understanding of sex-specific adipose tissue biology in HIV in South Africa, and possibly in other HIV endemic settings in SSA.
目前尚不清楚撒哈拉以南非洲地区感染艾滋病毒者（PWH）中不断上升的肥胖率如何影响他们患2型糖尿病（糖尿病）的风险。我们利用南非全国成年PWH及其未感染艾滋病毒的同龄人（PWOH）的横断面样本，研究了艾滋病毒与体重指数（BMI）、腰围（WC）和腰高比（WtHR）范围内的糖尿病患病率之间的关联。分析按性别分层，并对年龄、社会人口学和行为因素进行了调整。在所有肥胖水平下，PWH男性和PWOH男性的糖尿病患病率总体相似。相比之下，女性PWOH的总体糖尿病患病率高于女性PWH。然而，根据肥胖程度存在差异，与女性PWOH相比，女性PWH的相对糖尿病患病率在肥胖时降低，但在消瘦时加剧。肥胖与糖尿病之间关系的这些差异因艾滋病毒血清学状态而异，这需要更好地从机制上理解南非艾滋病毒中性别特异性脂肪组织生物学，可能在撒哈拉以南非洲的其他艾滋病毒流行地区也是如此。
