Case-control study of diabetes mellitus in hiv-infected patients

Myristicin has been documented to cause vertigo deafness hypotension a lowered pulse rate and paralysis Burning and itching at insulin injection sites. Pengaturan Makanan Bagi Diabetisi. In other words Insulin Resistance is the sluggish reaction of body diabetes food database tissues to insulin at normal insulin levels when insulin diabetes mellitus yoga is supposed to be enabling glucose metabolism.

Case-control study of diabetes mellitus in hiv-infected patients

Median levels for all markers, except hs-CRP, decreased from week 0 to week After further adjustment for week 48 glucose, effects were attenuated and only sTNFR1 remained significant odds ratio, highest quartile vs. These findings suggest that systemic inflammation may contribute to diabetes pathogenesis among HIV-infected patients.

With the advent of effective antiretroviral therapy ARTmorbidity and mortality have decreased dramatically among HIV-infected patients and the proportion of older HIV-infected patients is rising.

As a result, aging-related comorbidities, such as diabetes, have become increasingly important in the management of HIV-infected patients. Abnormalities in glucose metabolism occur commonly in HIV-infected patients, and some cohorts have shown a higher than expected risk of insulin resistance and diabetes compared with that for HIV-negative control populations 12.

The etiology is multifactorial. Certain protease inhibitors, such as indinavir IDVlopinavir, and ritonavir, have been shown to reversibly induce insulin resistance, probably by inhibition of glucose translocation through GLUT4 3.

The nucleoside reverse transcriptase inhibitors, zidovudine and stavudine, also have direct and indirect effects on glucose metabolism 45. Systemic inflammation has been associated with incident diabetes in multiple cohorts in the general population 7 — 9.

Among HIV-infected patients, markers of systemic inflammation decrease quickly with ART initiation 11 but do not normalize It is speculated that this residual inflammation with effective ART may contribute to the pathogenesis of comorbidities in HIV-infected patients, including diabetes We undertook a case-control study, nested within an observational study of the AIDS Clinical Trial Group ACTG to determine whether markers of systemic inflammation measured 48 weeks after ART initiation were associated with the development of diabetes.

Case-control study of diabetes mellitus in hiv-infected patients

Individuals could be treatment-naive or treatment-experienced at entry into their parent study. As of October3, previously treatment-naive individuals and 1, treatment-experienced individuals were enrolled into ALLRT.

All subjects provided written informed consent, and each ACTG study site received approval from the designated institutional review board before protocol initiation.

The eligible population for this prospective, nested case-control study included all HIV-infected individuals from treatment-naive parent studies co-enrolled in ALLRT, with the exception of parent studies for which ART data were still blinded.

Eligible individuals were required to have had fasting or nonfasting blood glucose measurements before and after ART initiation and during the follow-up period, as well as plasma samples taken at the time of treatment initiation and at week 48, for measurement of inflammatory markers.

We used data submitted to our data management center as of October Control subjects were matched to case subjects 1: Control subjects were followed for at least as long as their matched case subject. The glucose and medication histories of each of these case subjects and control subjects were reviewed by hand by an endocrinologist T.

Laboratory methods After identification of case subjects and control subjects, frozen plasma samples at weeks 0 and 48 were pulled from the repository at the same time and forwarded to the Johns Hopkins Bayview Advanced Chemistry Laboratory Baltimore, MD. Markers were measured in duplicate using commercially available enzyme-labeled immunosorbent sandwich assays, and values were averaged for analysis.

The intra-assay precision of these assays range from 4. The sensitivity of this assay system for these cytokines ranged from 0. The linear range of the assay standards is 0. The first high glucose level and the diagnosis date had to occur at least 1 year after ART initiation. Baseline levels of each marker were natural log-transformed.

Statistical analysis Demographic, health, and treatment characteristics were summarized and compared between case subjects and control subjects. Differences in marker levels at baseline and at week 48 were also summarized and compared using the Wilcoxon signed-rank test.

Conditional logistic regression was used to model the association between week 48 levels of each inflammatory marker and diabetes incidence, taking into account matching and adjusting for the other potential confounders.

The lowest marker quartile was the reference category in each model. Each model included categories of week 48 marker quartile, natural log-transformed baseline marker level and age.

To assess trend in diabetes incidence over marker quartiles, quartiles for each marker were included in the model as ordinal variables.


Because of concern that hyperglycemia in the nondiabetic range may lead to inflammation, we reevaluated each model after adjustment for glucose values at 48 weeks. In these models, a variable indicating whether the glucose determination was made in the fasting state yes or no was also included.Background: Diabetes mellitus (DM) is more prevalent among patients with HIV infection.

Besides protease inhibitors (PIs), other factors may contribute to the development of DM. Objective: To assess characteristics associated with the development of DM in HIV-infected persons.

Case-control study of diabetes mellitus in hiv-infected patients

Methods: We conducted a case-control study in an urban HIV clinic among patients with incident DM (49 cases) matched. Methods: We conducted a case-control study in an urban HIV clinic among patients with incident DM (49 cases) matched to 2 controls (n = 98) on age ±5 years, race, sex, and length of clinic follow-up.

There was a second set of unmatched controls (n = ). In this case-control study nested within a multicenter, observational cohort of HIV-infected individuals receiving ART, we found that, despite a decrease in most inflammatory markers with ART initiation, markers of TNF-α activation 48 weeks after treatment were associated with incident diabetes.

Tenofovir-related nephrotoxicity in human immunodeficiency virus-infected patients: Three cases of renal failure, Fanconi syndrome, and nephrogenic diabetes insipidus.

Fanconi syndrome associated with use of tenofovir in HIV-infected patients: A case report and review of the literature. AIDS Read –, A case-control study. Sep 19,  · Rodríguez-Nóvoa S, Labarga P, Soriano V, Egan D, Albalater M, Morello J, Cuenca L, González-Pardo G, Khoo S, Back D, Owen A.: Predictors of kidney tubular dysfunction in HIV-infected patients treated with tenofovir: A pharmacogenetic study.

A retrospective case-control study was conducted at 4 sites. Each HIV-infected patient with DM (n=48) was matched with 2 HIV-infected controls (n=) by age (±2 years) and sex.

HIV-infected patients are at an increased risk for developing Diabetes