Prediabetes and diabetes among HIV-infected adults in Cameroon

• Published in: Diabetes/metabolism research and reviews Vol. 32; no. 6; pp. 544 - 549
• Main Authors: Rhee, John Y., Bahtila, Tumi Divine, Palmer, Dennis, Tih, Pius Muffih, Aberg, Judith A., LeRoith, Derek, Jao, Jennifer
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.09.2016; Wiley Subscription Services, Inc
• Subjects: Abdomen; Adult; Antiretroviral drugs; antiretroviral therapy; Biomarkers - analysis; Cameroon; Cameroon - epidemiology; Confidence intervals; Cross-Sectional Studies; Diabetes; Diabetes Mellitus - epidemiology; Diabetes Mellitus - etiology; Female; Glycated Hemoglobin A - analysis; Health risk assessment; HIV; HIV Infections - complications; HIV Infections - virology; HIV-1 - physiology; Human immunodeficiency virus; Humans; Hypertension; Lentivirus; Male; Middle Aged; Prediabetic State - epidemiology; Prediabetic State - etiology; Prevalence; Prognosis; Retroviridae; prevalence; Cameroon; HIV; diabetes; antiretroviral therapy
• ISSN: 1520-7552; 1520-7560
• DOI: 10.1002/dmrr.2792

Background Human immunodeficiency virus (HIV) and certain antiretrovirals are associated with diabetes. Few studies have examined the prevalence of and factors associated with diabetes among HIV‐infected individuals on combination antiretroviral therapy (cART) in sub‐Saharan Africa; some report prevalence estimates between 3.5–26.5% for diabetes in Cameroon and 20.2–43.5% for prediabetes in sub‐Saharan Africa. Methods In a cross‐sectional study, HIV‐infected individuals (16–65 years old) were screened for diabetes using haemoglobin A1c (HbA1c). We further categorized HbA1C as normoglycemia (HbA1c < 5.7%), prediabetes (HbA1c 5.7–6.4%) or diabetes (HbA1c  ≥ 6.5%). Dysglycemia was defined as HbA1c ≥ 5.7%. Logistic regression modelling was used to assess factors associated with having dysglycemia. Results Of 500 participants, 363 (72.6%) were female. Median age was 42.5 years [interquartile range (IQR): 36.5–49.5]. Nineteen patients (3.8%) had diabetes and 170 patients (34%) were classified as having prediabetes. One hundred nine (22%) had a CD4+ count <200 cells/mm3, and 464 (93%) had received >28 days of ART at time of screening. Median abdominal circumference for women was 79.5 cm (IQR: 75.5–85.3) and for men, 86.5 cm (IQR: 81.7–90.5). Adjusting for age, sex, socio‐economic status, CD4 cell count, being on cART >28 days, body mass index, hypertension, history of hypertension, abdominal circumference and duration of HIV infection, larger abdominal circumference was associated with higher prevalence of prediabetes or diabetes (adjusted odds ratio = 1.07, 95% confidence interval: 1.03–1.11), while being on cART (adjusted odds ratio = 0.46, confidence interval: 0.22–0.99) was associated with lower prevalence. Conclusions There was a high prevalence of dysglycemia among Cameroonian HIV‐infected adults. Larger abdominal circumference was associated with higher prevalence, while cART was associated with lower prevalence. Copyright © 2016 John Wiley & Sons, Ltd.