Multiple risk factors found for diabetes in HIV-positive HAART patients

Michael Carter
Estimated reading time 2 minutes
This article is more than 22 years old.

Patients treated with HAART who are obese when anti-HIV treatment is initiated, those who have taken protease inhibitors for longer, and those who have lipodystrophy are at greater risk of developing diabetes mellitus, according to Spanish research published as research correspondence in the April 2003 edition of AIDS.

Investigators in Malaga, Spain conducted a case control study involving 745 HAART patients between 1997 and 2001.

In total 34 cases (4.5% of the patient population) of diabetes mellitus were diagnosed and 71 patients (9.5%) had glucose intolerance. These patients were matched with controls of the same age, weight and sex.

Glossary

diabetes

A group of diseases characterized by high levels of blood sugar (glucose). Type 1 diabetes occurs when the body fails to produce insulin, which is a hormone that regulates blood sugar. Type 2 diabetes occurs when the body either does not produce enough insulin or does not use insulin normally (insulin resistance). Common symptoms of diabetes include frequent urination, unusual thirst and extreme hunger. Some antiretroviral drugs may increase the risk of type 2 diabetes.

lipodystrophy

A disruption to the way the body produces, uses and distributes fat. Different forms of lipodystrophy include lipoatrophy (loss of subcutaneous fat from an area) and lipohypertrophy (accumulation of fat in an area), which may occur in the same person.

multivariate analysis

An extension of multivariable analysis that is used to model two or more outcomes at the same time.

body mass index (BMI)

Body mass index, or BMI, is a measure of body size. It combines a person's weight with their height. The BMI gives an idea of whether a person has the correct weight for their height. Below 18.5 is considered underweight; between 18.5 and 25 is normal; between 25 and 30 is overweight; and over 30 is obese. Many BMI calculators can be found on the internet.

case-control study

An observational study in which a group of people with an infection or condition (called ‘cases’) are compared with a group of people without the infection or condition (called ‘controls’). The past events and behaviour of the two groups are compared. Case-control studies can help us understand the risk factors for having an infection or a condition. However, it is difficult both to accurately collect information about past events and to eliminate bias from case-control studies.

Investigators looked at possible risk factors for diabetes mellitus including a family history of the condition, body mass index when HIV infection was first diagnosed, risk factors for HIV infection, and type and duration of anti-HIV therapy.

In univariate analysis patients with diabetes were found to be more likely to have a family history of diabetes, be obese, and have lipodystrophy. However, multivariate analysis showed that only obesity (BMI> 27.3kg/m2 at the time when anti-HIV therapy was first started, duration of treatment with a protease inhibitor, and lipodystrophy were significant.

The investigators conclude that “our research suggests a multifactorial aetiology of d(iabetes) m(ellitus) in patients with HIV infection” with personal, genetic and HIV-associated factors all playing a role. They recommend that all patients should be checked for risk factors of diabetes before starting HAART and should be regularly reevaluated.

Further information on this website

Daibetes - overview

Body fat changes on HAART (lipodystrophy) - overview

References

Rosario P et al. Factors associated with the development of diabetes mellitus in HIV-infected patients on antiretroviral therapy: a case controlled study. AIDS 17:933 – 935, 2003.

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