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Impact of therapeutic, anthropometric and genetic factors on glucose metabolism in HIV‐patients – a reason for glycemic control?
Author(s) -
Blass Sandra,
Ellinger Sabine,
Spengler Ulrich,
Rockstroh Jürgen K.,
von Rücker Alexander,
Stehle Peter
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.4.a593-c
Subject(s) - medicine , overweight , glycemic , insulin resistance , body mass index , endocrinology , waist , anthropometry , carbohydrate metabolism , diabetes mellitus , obesity
HIV patients with antiretroviral therapy (ART) are prone to develop disorders of glucose (Glc) metabolism at a yet unknown frequency. The aim of our study was to identify patients with disorders of Glc metabolism taking into account ART, familial disposition (FD) for diabetes mellitus (DM) and anthropometric parameters. Plasma Glc, insulin, c‐peptide and insulin resistance (homeostasis model, HOMA) were determined in 46 HIV patients [6 without ART, 19 with protease inhibitors (PI), 9 without PI (non‐PI)] and 11 healthy subjects. Glc tolerance was determined by standard procedures. Body mass index, triceps skin fold thickness, waist circumference, waist‐to‐hip‐ratio, fat/fat‐free mass were measured and FD for DM was assessed. Fasting plasma Glc levels >100 mg/dl were documented in 35% of ART‐patients (21% with PI, 14% non‐PI) but in none of ART‐naive and healthy controls. 58% of PI, 44% of non‐PI, 38% of ART‐naive and none of healthy controls had a HOMA‐index >2.5 which indicates insulin resistance. Compared to ART‐naive and healthy controls, ART patients had significantly higher fasting Glc levels. Anthropometric parameters did not differ in the 4 groups. Duration of ART, overweight and FD for DM significantly affected fasting Glc among PI users. HIV patients on long‐term PI therapy, with overweight and FD for DM are at high risk to develop disorders of Glc metabolism. The efficacy of dietary measures should be investigated in these patients.