Case-control study of diabetes mellitus in HIV-infected patients.
BACKGROUND
Diabetes mellitus (DM) is more prevalent among patients with HIV infection. Besides protease inhibitors (PIs), other factors may contribute to the development of DM.


OBJECTIVE
To assess characteristics associated with the development of DM in HIV-infected persons.


METHODS
We conducted a case-control study in an urban HIV clinic among patients with incident DM (49 cases) matched to 2 controls (n = 98) on age +/-5 years, race, sex, and length of clinic follow-up. There was a second set of unmatched controls (n = 196).


RESULTS
Compared with matched controls, case patients had higher mean body mass index (BMI; 30.0 vs. 25.3 kg/m, matched odds ratio [OR] = 1.20; P < 0.001), higher alanine aminotransferase (ALT; 66 vs. 44 U/L, OR = 1.12 per 10 U/L; P = 0.013), and stronger family history of DM (50% vs. 29%, OR = 3.30; P = 0.009). Hepatitic C virus coinfection and PI use were not significant factors. In unmatched controls, there was no significant difference in age, sex, or ethnicity. In multivariate analyses, BMI (OR = 1.13 per kg/m; P = 0.012), family history (OR = 5.55; P = 0.014), and ALT (OR = 1.16; P = 0.012) were associated with DM.


CONCLUSIONS
These findings suggest a complex interaction among genetic factors, body composition, and liver injury in the pathogenesis of DM in HIV-infected patients.
Yoon
Cecilia
C
Department of Medicine, Weill Medical College, Cornell University, New York, NY 10011, USA. cjy2001@nyp.org
Gulick
Roy M
RM
Hoover
Donald R
DR
Vaamonde
Carlos M
CM
Glesby
Marshall J
MJ
D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D016022:Case-Control Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000235:genetics; D005192:Family Health; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000201:enzymology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
D000410:Alanine Transaminase