1406例初治AIDS病人的高血糖发生率及其高危因素的多中心研究

A multicenter study of the prevalence and risk factors of hyperglycemia among Chinese antiretroviral-naive AIDS patients

目的 了解初治艾滋病（AIDS）病人的高血糖发生率及其高危因素。方法 在全国23个分中心共筛查1406例未接受抗病毒治疗的AIDS病人,采用横断面的研究方法,研究初治AIDS病人高血糖的发生率,对其影响因素进行单因素及多因素Logistic回归分析。结果 1406例AIDS病人中,高血糖的发生率为5.3%（75例）,其中糖尿病的发生率为1.7%（24例）。多因素分析结果显示,年龄≥40岁[比值比（OR）=3.748,95%可信区间（CI）：2.057~6.829]、体质指数（OR=1.102,95%CI：1.015~1.196）是初治AIDS病人发生高血糖的高危因素,而艾滋病病毒（HIV）感染本身与高血糖无相关性。24例艾滋病合并糖尿病病人中,13例病人（54.2%）未被临床医生诊断为糖尿病。结论 初治AIDS病人中,高血糖的发生率低。年龄≥40岁及超重是发生高血糖的高危因素,HIV感染不是高血糖的高危因素。初治艾滋病病人中糖尿病的漏诊率较高,感染科医生应该重视初治艾滋病病人中合并糖尿病的诊断。

Objective To investigate the prevalence of hyperglycemia and its risk factors among Chinese antiret- roviral-naive acquired immunodeficiency syndrome （AIDS） patients. Methods A total of 1406 AIDS patients were screened at 23 sites in China. A cross-sectional study was conducted to obtain the prevalence of hyperglycemia a- mong antiretroviral-naive AIDS patients. Univariate and multivariate logistic regression analyses were used to deter- mine the risk factors of hyperglycemia among AIDS patients. Results Among 1406 AIDS patients, the prevalence of hyperglycemia and diabetes were 5.3 % （75 cases）） and 1.7% （24 cases） respectively. Multivariate logistic regres- sion analysis demonstrated that age elder than 40 years （OR= 3. 748, 95 YooCI（2. 057, 6. 829）） and body mass index （OR= 1. 102,95 %CI（1. 015, 1. 196）） were risk factors associated with hyperglycemia. However, HIV infection it- self was not the risk factor of hyperglycemia. Among 24 AIDS patients with diabetes, 13 patients （54.2%） were not diagnosed as diabetes by clinicians. Conclusion Among antiretroviral-naive AIDS patients, the prevalence of hy- perglycemia is low. Age elder than 40 years and obesity are the risk factors of hyperglycemia. HIV infection itself is not the risk factor of hyperglycemia. The rate of misdiagnosis of diabetes is relatively high among AIDS patients. The doctors of the infectious diseases should pay attention to the diagnosis of diabetes among antiretroviral-naive AIDS patients.