title: Prediabetes and diabetes among HIV-infected adults in Cameroon.
abstract: 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.
  
  
  
  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.
  
  
  
  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/mm(3) , 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.
  
  
  
  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.
authors.affiliation: Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: John Y
authors.initials: JY
authors.lastname: Rhee
authors.affiliation: Cameroon Baptist Convention Health Services, Bamenda, Cameroon.
authors.forename: Tumi Divine
authors.initials: TD
authors.lastname: Bahtila
authors.affiliation: Cameroon Baptist Convention Health Services, Bamenda, Cameroon.
authors.forename: Dennis
authors.initials: D
authors.lastname: Palmer
authors.affiliation: Cameroon Baptist Convention Health Services, Bamenda, Cameroon.
authors.forename: Pius Muffih
authors.initials: PM
authors.lastname: Tih
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Aberg
authors.affiliation: Department of Medicine, Division of Endocrinology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Derek
authors.initials: D
authors.lastname: LeRoith
authors.affiliation: Department of Medicine, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jao
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015658:HIV Infections / Q000150:complications / Q000821:virology*; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011379:Prognosis
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Cameroon; HIV; antiretroviral therapy; diabetes; prevalence