title: Prevalence of insulin resistance and risk of diabetes mellitus in HIV-infected patients receiving current antiretroviral drugs.
abstract: OBJECTIVE
  HIV-infected patients had a higher prevalence of insulin resistance (IR) and risk of diabetes mellitus (DM) than that observed in healthy controls, but there are no data about the current prevalence considering the changes in HIV presentation and the use of newer antiretroviral drugs.
  
  
  METHODS
  Longitudinal study which involved 265 HIV patients without DM, receiving first (n=71) and advanced lines of antiretroviral therapy (n=194).
  
  
  METHODS
  Prevalence of IR according to clinical and anthropometric variables, including dual X-ray absorptiometry (DXA) scan evaluation. IR was defined as homeostasis model assessment of IR≥3.8. Incident DM was assessed during the follow-up.
  
  
  RESULTS
  First-line patients had a short time of HIV infection, less hepatitis C virus coinfection, and received mainly an efavirenz-based regimen. Overall, the prevalence of IR was 21% (55 patients, 6% in first-line, 27% in pretreated). In a logistic regression analysis, significant associations were found between the waist/hip circumference ratio (RR 10; 95% CI 1.66-16; P<0.01, per unit), and central fat in percentage (RR 1.08; 95% CI 1.01-1.17; P=0.04, per unit) as evaluated by DXA, and IR. During 770.8 patient-years, DM was diagnosed in 8% (22 patients), mostly in pretreated patients (10 vs 4%; P=0.1). Thus, the overall rate of incident DM was 2.85 per 100 person-years, mostly in previous IR (10.39 vs 0.82/100 person-years; P=0.01).
  
  
  CONCLUSIONS
  A lower prevalence of IR is observed in the current HIV-infected patients with fewer risk factors and receiving newer antiretroviral drugs. IR continues to identify patients at high risk for developing DM in the short term.
authors.affiliation: Department of Infectious DiseasesRamon y Cajal Hospital, Cra. Colmenar, Km 9.1, 28034 Madrid, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Araujo
authors.affiliation: Department of Infectious DiseasesRamon y Cajal Hospital, Cra. Colmenar, Km 9.1, 28034 Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Bañón
authors.affiliation: Department of Infectious DiseasesRamon y Cajal Hospital, Cra. Colmenar, Km 9.1, 28034 Madrid, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Machuca
authors.affiliation: Department of Infectious DiseasesRamon y Cajal Hospital, Cra. Colmenar, Km 9.1, 28034 Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Moreno
authors.affiliation: Department of Infectious DiseasesRamon y Cajal Hospital, Cra. Colmenar, Km 9.1, 28034 Madrid, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Pérez-Elías
authors.affiliation: Department of Infectious DiseasesRamon y Cajal Hospital, Cra. Colmenar, Km 9.1, 28034 Madrid, Spain jose.casado@salud.madrid.org.
authors.forename: José L
authors.initials: JL
authors.lastname: Casado
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D015497:HIV-1; D006801:Humans; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors