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Insulin resistance change and antiretroviral therapy exposure in HIV-infected and uninfected Rwandan women: a longitudinal analysis.

Mutimura E, Hoover DR, Shi Q, Dusingize JC, Sinayobye JD, Cohen M, Anastos K - PLoS ONE (2015)

Bottom Line: While ART use did not predict change in log10-HOMA, untreated HIV+ women had a significant decline in IR over time.Use or duration of AZT, d4T and EFV was not associated with HOMA change in HIV+ women.Exposure to specific ART (d4T, AZT, EFV) did not predict insulin resistance change in ART-treated HIV-infected Rwandan women.

View Article: PubMed Central - PubMed

Affiliation: Regional Alliance for Sustainable Development (RASD Rwanda) Kigali, Rwanda.

ABSTRACT

Background: We longitudinally assessed predictors of insulin resistance (IR) change among HIV-uninfected and HIV-infected (ART-initiators and ART-non-initiators) Rwandan women.

Methodology: HIV-infected (HIV+) and uninfected (HIV-) women provided demographic and clinical measures: age, body mass index (BMI) in Kg/(height in meters)2, Fat-Mass (FMI) and Fat-Free-Mass (FFMI) index, fasting serum glucose and insulin. Homeostasis Model Assessment (HOMA) was calculated to estimate IR change over time in log10 transformed HOMA measured at study enrollment or prior to ART initiation in 3 groups: HIV- (n = 194), HIV+ ART-non-initiators (n=95) and HIV+ ART-initiators (n=371). ANCOVA linear regression models of change in log10-HOMA were fit with all models included the first log10 HOMA as a predictor.

Results: Mean±SD log10-HOMA was -0.18±0.39 at the 1st and -0.21±0.41 at the 2nd measure, with mean change of 0.03±0.44. In the final model (all women) BMI at 1st HOMA measure (0.014; 95% CI=0.006-0.021 per kg/m2; p<0.001) and change in BMI from 1st to 2nd measure (0.024; 95% CI=0.013-0.035 per kg/m2; p<0.001) predicted HOMA change. When restricted to subjects with FMI measures, FMI at 1st HOMA measure (0.020; 95% CI=0.010-0.030 per kg/m2; p<0.001) and change in FMI from 1st to 2nd measure (0.032; 95% CI=0.020-0.043 per kg/m2; p<0.0001) predicted change in HOMA. While ART use did not predict change in log10-HOMA, untreated HIV+ women had a significant decline in IR over time. Use or duration of AZT, d4T and EFV was not associated with HOMA change in HIV+ women.

Conclusions: Baseline BMI and change in BMI, and in particular fat mass and change in fat mass predicted insulin resistance change over ~3 years in HIV-infected and uninfected Rwandan women. Exposure to specific ART (d4T, AZT, EFV) did not predict insulin resistance change in ART-treated HIV-infected Rwandan women.

No MeSH data available.


Related in: MedlinePlus

Flow Diagram RWISA longitudinal insulin resistance study; RWISA, Rwanda Women’s Interassociation Study Assessment; HIV, Human immunodeficiency virus; ART, antiretroviral therapy; HIV+, HIV-infected; HIV-, HIV-uninfected.
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pone.0123936.g001: Flow Diagram RWISA longitudinal insulin resistance study; RWISA, Rwanda Women’s Interassociation Study Assessment; HIV, Human immunodeficiency virus; ART, antiretroviral therapy; HIV+, HIV-infected; HIV-, HIV-uninfected.

Mentions: As shown in Fig 1, of the 710 HIV+ participants at baseline, 490 (69.0%) initiated ART by 5th visit. Of these 490 participants, 5 died, 78 were lost to follow up (LTFU) and 36 had no available specimens leaving a total of 371 HIV+ ART initiators. Of the 710 HIV+ participants, 220 were non- ART initiators, of whom 15 died, 15 were LTFU and 95 had no specimens available leaving a total of 95 ART non-initiators. Of the 226 HIV uninfected participants, 1 died, 6 were LTFU and 25 had no available specimens leaving a total of 194 HIV- participants. Thus, a total of 660 women (194 HIV-uninfected, 95 HIV-infected ART non-initiators and 371 HIV-infected ART initiators) were included in this longitudinal analysis. FMI and FFMI at both HOMA measures was not available from 97 (15%) of the final women (Fig 1).


Insulin resistance change and antiretroviral therapy exposure in HIV-infected and uninfected Rwandan women: a longitudinal analysis.

Mutimura E, Hoover DR, Shi Q, Dusingize JC, Sinayobye JD, Cohen M, Anastos K - PLoS ONE (2015)

Flow Diagram RWISA longitudinal insulin resistance study; RWISA, Rwanda Women’s Interassociation Study Assessment; HIV, Human immunodeficiency virus; ART, antiretroviral therapy; HIV+, HIV-infected; HIV-, HIV-uninfected.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400132&req=5

pone.0123936.g001: Flow Diagram RWISA longitudinal insulin resistance study; RWISA, Rwanda Women’s Interassociation Study Assessment; HIV, Human immunodeficiency virus; ART, antiretroviral therapy; HIV+, HIV-infected; HIV-, HIV-uninfected.
Mentions: As shown in Fig 1, of the 710 HIV+ participants at baseline, 490 (69.0%) initiated ART by 5th visit. Of these 490 participants, 5 died, 78 were lost to follow up (LTFU) and 36 had no available specimens leaving a total of 371 HIV+ ART initiators. Of the 710 HIV+ participants, 220 were non- ART initiators, of whom 15 died, 15 were LTFU and 95 had no specimens available leaving a total of 95 ART non-initiators. Of the 226 HIV uninfected participants, 1 died, 6 were LTFU and 25 had no available specimens leaving a total of 194 HIV- participants. Thus, a total of 660 women (194 HIV-uninfected, 95 HIV-infected ART non-initiators and 371 HIV-infected ART initiators) were included in this longitudinal analysis. FMI and FFMI at both HOMA measures was not available from 97 (15%) of the final women (Fig 1).

Bottom Line: While ART use did not predict change in log10-HOMA, untreated HIV+ women had a significant decline in IR over time.Use or duration of AZT, d4T and EFV was not associated with HOMA change in HIV+ women.Exposure to specific ART (d4T, AZT, EFV) did not predict insulin resistance change in ART-treated HIV-infected Rwandan women.

View Article: PubMed Central - PubMed

Affiliation: Regional Alliance for Sustainable Development (RASD Rwanda) Kigali, Rwanda.

ABSTRACT

Background: We longitudinally assessed predictors of insulin resistance (IR) change among HIV-uninfected and HIV-infected (ART-initiators and ART-non-initiators) Rwandan women.

Methodology: HIV-infected (HIV+) and uninfected (HIV-) women provided demographic and clinical measures: age, body mass index (BMI) in Kg/(height in meters)2, Fat-Mass (FMI) and Fat-Free-Mass (FFMI) index, fasting serum glucose and insulin. Homeostasis Model Assessment (HOMA) was calculated to estimate IR change over time in log10 transformed HOMA measured at study enrollment or prior to ART initiation in 3 groups: HIV- (n = 194), HIV+ ART-non-initiators (n=95) and HIV+ ART-initiators (n=371). ANCOVA linear regression models of change in log10-HOMA were fit with all models included the first log10 HOMA as a predictor.

Results: Mean±SD log10-HOMA was -0.18±0.39 at the 1st and -0.21±0.41 at the 2nd measure, with mean change of 0.03±0.44. In the final model (all women) BMI at 1st HOMA measure (0.014; 95% CI=0.006-0.021 per kg/m2; p<0.001) and change in BMI from 1st to 2nd measure (0.024; 95% CI=0.013-0.035 per kg/m2; p<0.001) predicted HOMA change. When restricted to subjects with FMI measures, FMI at 1st HOMA measure (0.020; 95% CI=0.010-0.030 per kg/m2; p<0.001) and change in FMI from 1st to 2nd measure (0.032; 95% CI=0.020-0.043 per kg/m2; p<0.0001) predicted change in HOMA. While ART use did not predict change in log10-HOMA, untreated HIV+ women had a significant decline in IR over time. Use or duration of AZT, d4T and EFV was not associated with HOMA change in HIV+ women.

Conclusions: Baseline BMI and change in BMI, and in particular fat mass and change in fat mass predicted insulin resistance change over ~3 years in HIV-infected and uninfected Rwandan women. Exposure to specific ART (d4T, AZT, EFV) did not predict insulin resistance change in ART-treated HIV-infected Rwandan women.

No MeSH data available.


Related in: MedlinePlus