Incidence and associated factors of type 2 diabetes mellitus onset in the Brazilian HIV/AIDS cohort study

Autor(es)

Cassenote, Alex J. F. ^{[1, 2, 3]} ; Grangeiro, Alexandre ^[4] ; Escuder, Maria M. ^[5] ; Abe, Jair M. ^[6] ; Santos, Raul D. ^[7] ; Segurado, Aluisio C. ^[8]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, Dept Gastroenterol, Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Dept Prevent Med, Fac Med, Med Demog Study Grp MDSG, Sao Paulo, SP - Brazil

^[3] Santa Marcelina Fac, Discipline Lab Market & Phys Hlth, Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Fac Med, Dept Prevent Med, Sao Paulo, SP - Brazil

^[5] Sao Paulo State Dept Hlth, Hlth Inst, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Inst Adv Studies, Sao Paulo, SP - Brazil

^[7] Univ Sao Paulo, Hosp Clin, Fac Med, Heart Inst InCor, Sao Paulo, SP - Brazil

^[8] Univ Sao Paulo, Hosp Clin, Fac Med, Dept & Div Infect & Parasit Dis, Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Brazilian Journal of Infectious Diseases; v. 25, n. 4 JUL-AUG 2021.
• Citações Web of Science: 0

Resumo

Background: People living with HIV (PLH) under combined antiretroviral therapy (cART) are at risk of developing type 2 diabetes mellitus (T2DM). Objective: We examined the incidence of T2DM, associated factors and mean time to outcome in PLH under cART. Method: Data for this multicenter cohort study were obtained from PLH aged over 18, who started cART in 13 Brazilian sites from 2003 to 2013. Factors associated with incident T2DM were evaluated by Cox multiple regression models. Results: A total of 6724 patients (30,997.93 person-years) were followed from January 2003 to December 2016. A T2DM incidence rate of 17.3/1000 person-years (95%CI 15.8-18.8) was observed. Incidence of isolated hypertriglyceridemia and impaired fasting glucose (IFG) were 84.3 (95%CI 81.1-87.6) and 14.5/1000 person-years (95%CI 13.2-15.9), respectively. Mean time to T2DM onset was 10.5 years (95%CI 10.3-10.6). Variables associated with incident T2DM were age 40-50 {[}Hazard Ratio (HR) 1.7, 95%CI 1.4-2.1] and > 50 years (HR 2.4, 95%CI 1.9-3.1); obesity (HR 2.1, 95%CI 1.6-2.8); abnormal triglyceride/HDL-cholesterol ratio (HR 1.8, 95%CI 1.51-2.2). IFG predicted T2DM (HR 2.6, 95%CI 1.7-2.5) and occurred on average 3.3 years before diabetes onset. Exposure to stavudine for > 2 years was independently associated with incident T2DM {[}HR 1.6, 95%CI 1.0-2.2). Conclusion: Brazilian PLH under cART are at significant risk of developing T2DM and share risk factors for diabetes onset with the general population, such as older age, obesity, and having metabolic abnormalities at baseline. Moreover, stavudine use was independently associated with incident T2DM. Identifying PLH at a higher risk of T2DM can help caretakers trigger health promotion and establish specific targets for implementation of preventive measures. (c) 2021 Published by Elsevier Espana, S.L.U. on behalf of Sociedade Brasileira de Infectologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) (AU)

• Processo FAPESP: 13/18158-0 - Alterações metabólicas associadas ao uso de medicamento antirretroviral em pessoas vivendo com HIV/AIDS: caracterização e desenvolvimento de algoritmos inteligentes aplicados à sua identificação e previsão
• Beneficiário: Alex Jones Flores Cassenote
• Modalidade de apoio: Bolsas no Brasil - Doutorado