Relationship of ethnicity and CD4 Count with glucose metabolism among HIV patients on Highly-Active Antiretroviral Therapy (HAART)

Ranjita Misra, Prakash Chandra, Steven E. Riechman, Dustin M. Long, Shivani Shinde, Henry J. Pownall, Ivonne Coraza, Dorothy E. Lewis, Rajagopal V. Sekhar, Ashok Balasubramanyam

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: HIV patients on HAART are prone to metabolic abnormalities, including insulin resistance, lipodystrophy and diabetes. This study purports to investigate the relationship of ethnicity and CD4+ T cell count attained after stable highly-active antiretroviral treatment (HAART) with glucose metabolism in hyperrtriglyceridemic HIV patients without a history of diabetes.Methods: Demographic, anthropometric, clinical, endocrinologic, energy expenditure and metabolic measures were obtained in 199 multiethnic, healthy but hypertriglyceridemic HIV-infected patients [46% Hispanic, 17% African-American, 37% Non-Hispanic White (NHW)] on stable HAART without a history of diabetes. The relationship of glucose and insulin responses to ethnicity, CD4 strata (low (<300/cc) or moderate-to-high (≥ 300/cc)), and their interaction was determined.Results: African-Americans had significantly greater impairment of glucose tolerance (P < 0.05) and HbA1c levels (P < .001) than either Hispanics or NHWs. In multivariate models, after adjusting for confounders (age, sex, HIV/HAART duration, smoking, obesity, glucose, insulin and lipids), African-Americans and Hispanics had significantly higher HbA1c and 2-hour glucose levels than NHW's. Demonstrating a significant interaction between ethnicity and CD4 count (P = 0.023), African Americans with CD4 <300/cc and Hispanics with CD4 ≥300/cc had the most impaired glucose response following oral glucose challenge.Conclusions: Among hypertriglyceridemic HIV patients on HAART, African-Americans and Hispanics are at increased risk of developing diabetes. Ethnicity also interacts with CD4+ T cell count attained on stable HAART to affect post-challenge glycemic response.

Original languageEnglish (US)
Article number13
JournalBMC Endocrine Disorders
Volume13
DOIs
StatePublished - Apr 22 2013

Keywords

  • African American
  • Dyslipidemia
  • HbA1c
  • Hispanic
  • Impaired glucose tolerance

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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