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2022年埃塞俄比亚西北部贡德尔大学医院接受基于多替拉韦的抗逆转录病毒治疗的成年HIV感染者高血糖的决定因素:一项病例对照研究

Determinants of Hyperglycemia in Adult People Living With HIV Taking Dolutegravir- Based Antiretroviral Therapy at University of Gondar Hospital, North West Ethiopia, 2022: A Case-Control Study.

作者信息

Liknaw Addisu, Tadesse Abilo, Hailu Workagegnehu, Tesfaye Tsebaot, Tadesse Melaku

机构信息

Woldia Comprehensive Specialized hospital, Woldia, North Wollo, Ethiopia.

Department of Internal medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

J Int Assoc Provid AIDS Care. 2025 Jan-Dec;24:23259582251375873. doi: 10.1177/23259582251375873. Epub 2025 Sep 9.

Abstract

BackgroundDolutegravir (DTG)-based antiretroviral treatment is now the recommended regimen because of its high efficacy and fewer adverse effects. Nonetheless, hyperglycemia as adverse effect of DTG was reported in few clinical observations.MethodsA case-control study was carried out among DTG-based antiretroviral therapy (ART) users during the study period. EPI Info version 4.8 and SPSS version 26 were used for data entry and analysis, respectively. Binary logistic regression model was used to determine association between risk factors and outcome measures. The associated factors of hyperglycemia were identified using the odds ratio. A value <.05 was used to test significance.ResultsThis study contained 42 cases (DTG-based ART users who developed hyperglycemia) and 84 controls (DTG-based ART users who didn't develop hyperglycemia). On bivariable analysis, lower base-line CD4 count, greater body mass index, and lower grade school attendees were significant at -value <.25. On multivariable analysis, overweight/obesity (body mass index ≥25) plausibly approached statistical significance but did not reach conventional threshold (-value<.05) as risk factor for hyperglycemia among DTG-based ART users.ConclusionOverweight/obesity-driven hyperglycemia secondary to insulin resistance might be the explanation for hyperglycemia among DTG-based ART users. Further studies with larger sample sizes and prospective designs are needed to confirm these findings.

摘要

背景

基于多替拉韦(DTG)的抗逆转录病毒治疗因其高效性和较少的不良反应,现已成为推荐方案。尽管如此,在少数临床观察中报告了DTG导致的高血糖不良反应。

方法

在研究期间,对接受基于DTG的抗逆转录病毒疗法(ART)的患者进行了病例对照研究。分别使用EPI Info 4.8版和SPSS 26版进行数据录入和分析。采用二元逻辑回归模型确定危险因素与结局指标之间的关联。使用比值比确定高血糖的相关因素。以<0.05的值检验显著性。

结果

本研究包括42例病例(发生高血糖的基于DTG的ART使用者)和84例对照(未发生高血糖的基于DTG的ART使用者)。在双变量分析中,较低的基线CD4计数、较高的体重指数和较低的小学入学率在P值<0.25时具有显著性。在多变量分析中,超重/肥胖(体重指数≥25)作为基于DTG的ART使用者发生高血糖的危险因素,似乎接近统计学显著性但未达到传统阈值(P值<0.05)。

结论

胰岛素抵抗继发的超重/肥胖驱动的高血糖可能是基于DTG的ART使用者发生高血糖的原因。需要进一步开展更大样本量和前瞻性设计的研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50dc/12420965/af0acf22ec3e/10.1177_23259582251375873-fig1.jpg

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