初治获得性免疫缺陷综合征男性患者的糖脂代谢特点

The glucolipid metabolism characteristics of newly diagnosed male patients with acquired immune deficiency syndrome

目的总结未接受高效抗反转录病毒治疗(HAART)的初治获得性免疫缺陷综合征(AIDS)男性患者的糖脂代谢特点。方法比较未行HAART的初治男性AIDS患者(病例组)与同期健康男性(对照组)的体重指数(BMI)、空腹血糖、血脂、血压、尿酸、胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能(HOMA-β)等糖脂代谢参数的差异。结果与对照组相比,病例组患者的空腹血糖显著升高(5.54 mmol/L vs 4.97 mmol/L,t=4.980、P=0.000),BMI和总胆固醇显著降低,且伴有明显的HOMA-β降低(20.46%vs 99.48%,t=5.011、P=0.000),差异均具有统计学意义。Pearson分析显示,HIV病毒载量与HOMA-IR呈负相关(r=-0.474,P=0.03),与HOMA-β有一定负相关关系,但差异无统计学意义(r=-0.368,P=0.077)。结论初治男性获得性免疫缺陷综合征患者常伴有空腹血糖升高和胰岛β细胞功能明显减退,且与HIV RNA载量有一定相关性,需定期监测血糖水平,警惕糖尿病的发生。

Objective To investigate the glucolipid metabolism characteristics of newly diagnosed acquired immune deficiency syndrome（AIDS） male patients before highly actively antiretroviral therapy（HAART）. Methods The glucolipid metabolism parameters including BMI, glucose, blood lipid, blood pressure, uric acid, HOMA-IR and HOMA-β between newly diagnosed male patients with AIDS before HAART（disease group） and synchronous healthy male（control group） were tested and analyzed, respectively. Results Compared with control group, patients in disease group had higher levels of fasting glucose（5.54 mmol/L vs 4.97 mmol/L; t = 4.980, P = 0.000） and lower level of BMI and total cholesterol, accompanied with more lower level of HOMA-β（20.46% vs 99.48%; t = 5.011, P = 0.000）. Pearson analysis showed that HIV virus load was negatively correlated with HOMA-IR（r =-0.474, P = 0.03） and HOMA-β（r =-0.368, P = 0.077）. Conclusions Newly diagnosed male patients with AIDS frequently have higher fasting glucose and hypofunction of pancreas islet β cells, which have certain relationship with HIV virus load. The monitor of glucose regularly should be paied attention and be vigilant on diabetes.