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

Authors

Ranjita Misra, West Virginia University
Prakash Chandra, Baylor College of Medicine
Steven E. Riechman, West Virginia University
Dustin M. Long, West Virginia University
Shivani Shinde, Baylor College of Medicine
Henry J. Pownall, Baylor College of Medicine
Ivonne Coraza, Baylor College of Medicine
Dorothy E. Lewis, University of Texas Medical Branch
Rajagopal V. Sekhar, Baylor College of Medicine
Ashok Balasubramanyam, Baylor College of Medicine

Author ORCID Identifier

https://orcid.org/0000-0001-7314-0184

N/A

https://orcid.org/0000-0001-9439-7560

https://orcid.org/0000-0002-5423-4481

N/A

https://orcid.org/0000-0001-8412-506X

N/A

https://orcid.org/0000-0001-6166-6111

https://orcid.org/0000-0001-9803-015X

https://orcid.org/0000-0003-2093-5201

Document Type

Article

Publication Date

2013

College/Unit

School of Public Health

Department/Program/Center

Social and Behavioral Sciences

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.

Digital Commons Citation

Misra, Ranjita; Chandra, Prakash; Riechman, Steven E.; Long, Dustin M.; Shinde, Shivani; Pownall, Henry J.; Coraza, Ivonne; Lewis, Dorothy E.; Sekhar, Rajagopal V.; and Balasubramanyam, Ashok, "Relationship of ethnicity and CD4 Count with glucose metabolism among HIV patients on Highly-Active Antiretroviral Therapy (HAART)" (2013). Faculty & Staff Scholarship. 2613.
https://researchrepository.wvu.edu/faculty_publications/2613

Source Citation

Misra, R., Chandra, P., Riechman, S.E. et al. Relationship of ethnicity and CD4 Count with glucose metabolism among HIV patients on Highly-Active Antiretroviral Therapy (HAART). BMC Endocr Disord 13, 13 (2013). https://doi.org/10.1186/1472-6823-13-13

Comments

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.