Prevalence Of & Factors Associated with Prediabetes & Diabetes among HIV-Infected Adults in Cameroon
BACKGROUND:
HIV and
certain antiretrovirals (ARVs) are associated with diabetes. Few studies have
examined the prevalence of and factors associated with diabetes amongst HIV-infected
individuals on combination antiretroviral therapy (cART) in sub-Saharan Africa;
some report prevalence estimates between 3.5-26.5% for diabetes in Cameroon and
20.2-43.5% for prediabetes in sub-Saharan Africa.
METHODS:
In a
cross-sectional study, HIV-infected individuals (16-65 years old) were
screened for diabetes using haemoglobin A1C (HbA1C ). We further categorized HbA1C as normoglycemia (HbA1C <5.7%),
prediabetes (HbA1C 5.7-6.4%), or diabetes (HbA1C ≥6.5%). Dysglycemia was defined as HbA1C ≥5.7%. Logistic regression modeling was used
to assess factors associated with having dysglycemia. .
RESULTS:
Of 500
participants, 363 (72.6%) were female. Median age was 42.5 years [Interquartile
Range (IQR):36.5-49.5]. Nineteen (3.8%) were diabetic, and 170 (34%) were
prediabetic. One hundred nine (22%) had a CD4+ count <200 cells/mm3 ,
and 464 (93%) had received >28 days of antiretroviral therapy (ART) at time
of screening. Median abdominal circumference for women was 79.5 cm (IQR:
75.5-85.3) and for men, 86.5 cm (IQR: 81.7-90.5). Adjusting for age, sex,
socio-economic status, CD4 cell count, being on cART >28 days, BMI,
hypertension, history of hypertension, abdominal circumference, and duration of HIV infection, larger abdominal circumference was
associated with higher prevalence of prediabetes or diabetes [adjusted Odds
Ratio (aOR)=1.07, 95% Confidence Interval (CI):1.03-1.11], while being on cART
(aOR=0.46, CI:0.22-0.99) was associated with lower prevalence.
CONCLUSIONS:
There
was a high prevalence of Cameroonian HIV-infected adults with dysglycemia. Larger
abdominal circumference was associated with higher prevalence, while cART was
associated with lower prevalence.
- 1Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- 2Cameroon Baptist Convention Health Services, Bamenda, Cameroon.
- 3Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- 4Department of Medicine, Division of Endocrinology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- 5Department of Medicine, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Diabetes Metab Res Rev. 2016 Feb 17. doi: 10.1002/dmrr.2792
No comments:
Post a Comment