Insulin resistance in HIV-infected men and women in the nutrition for healthy living cohort.
OBJECTIVE
We evaluated insulin resistance (IR) in an HIV-infected cohort and compared our results with those of the National Health and Nutrition Examination Survey III (NHANES III).


METHODS
Using a cross-sectional study design, we determined the Quantitative Insulin Sensitivity Check Index (QUICKI) in 378 nondiabetic participants in the Nutrition for Healthy Living (NFHL) study and evaluated the association of the QUICKI with demographic, socioeconomic, body composition, lipid, liver function, HIV-associated factors (CD4 cell count, viral load, highly active antiretroviral therapy type, and years infected), and injection drug use. The prevalence of IR (QUICKI <0.350) and the mean QUICKI were ascertained for nondiabetic persons aged 25 to 65 years in the NHANES III and compared with those in the NFHL study.


RESULTS
Protease inhibitor (PI) highly active antiretroviral therapy (HAART) and nonnucleoside reverse transcriptase inhibitor (NNRTI) HAART were associated with worse IR in HIV-infected men. Greater waist circumference, triglycerides, age, and alanine aminotransferase were associated with worse IR, and higher high-density lipoprotein, low-density lipoprotein, and smoking were associated with less IR in the NFHL study; CD4 cell count, viral load, and years HIV infected were not associated with IR. There was no significant difference in the prevalence of IR in the NFHL study versus the NHANES III (51% vs. 47%; P = 0.27). NFHL participants were not more IR than NHANES III participants.


CONCLUSIONS
IR in the NFHL study was quite common but not significantly different than in the NHANES III and was associated with similar factors as in the general population. PI HAART and NNRTI HAART were associated with worse IR in men.
Jones
Clara Y
CY
Division of Nutrition and Infectious Disease, Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, MA 02111, USA. clara.jones@tufts.edu
Wilson
Ira B
IB
Greenberg
Andrew S
AS
Shevitz
Abby
A
Knox
Tamsin A
TA
Gorbach
Sherwood L
SL
Spiegelman
Donna
D
Jacobson
Denise L
DL
Wanke
Christine
C
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001823:Body Composition; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009747:Nutritional Physiological Phenomena