深圳市初治HIV感染者高血糖患病率及影响因素分析

Prevalence and associated factors of hyperglycemia among antiretroviral-naive HIV-infected individuals in Shenzhen city, China

目的了解深圳市初治艾滋病病毒(HIV)感染者血糖异常的患病率及其影响因素。方法收集2015-2018年深圳市第三人民医院收治的未接受过抗病毒治疗(ART)的成年HIV感染者基本特征和临床资料,分析其高血糖患病率。采用多变量Logistic回归模型分析血糖异常的影响因素。结果共纳入5291例初治HIV感染者,高血糖的总患病率为6.88%(364例);其中空腹血糖受损和糖尿病患病率分别为4.55%(241例)、2.32%(123例)。多因素分析结果显示,年龄越大(≥35岁)、超重[比值比(OR)=1.83,95%可信区间(CI):1.38~2.43]、肥胖(OR=3.97,95%CI:2.52~6.26)、机会性感染(OR=2.75,95%CI:1.88~4.02)、高甘油三酯(TG)(OR=1.55,95%CI:1.20~1.99)是高血糖的独立危险因素;与HIV感染途径、CD4^+T淋巴细胞计数、CD8^+T淋巴细胞、世界卫生组织疾病分期、乙型肝炎病毒表面抗原、抗-丙型肝炎病毒、高血清总胆固醇、高低密度脂蛋白、低高密度脂蛋白等无明显相关。结论未接受ART的深圳成年HIV感染者高血糖患病率略高于当地一般人群。其中影响高血糖的危险因素主要为年龄较大、超重、肥胖、高TG、感染等传统因素。

Objective To explore the prevalence of hyperglycemia and associated factors among antiretroviral-naive HIV-infected individuals in Shenzhen,China.Methods Antiretroviral-naive HIV-infected individuals were enrolled during Jan,2015 and Dec,2018,and their demographics and medical histories were collected for the analysis of prevalence of hyperglycemia among the HIV-infected patients.The associated factors with hyperglycemia were identified using multivariable logistic regression.Results There were 5291 antiretroviral-naive HIV-infected individuals enrolled.The overall prevalence of hyperglycemia was 6.88%(364).The overall prevalence of impaired fasting glucose and diabetes was 4.55%(241/5291)and 2.32%(123/5291),respectively.Elder,overweight,obesity,high triglycerides,and opportunistic infections were the independent factors of hyperglycemia.We did not observe the significant influence of HIV transmission routes,CD4 count,CD8 count,WHO disease stage,HBsAg,anti-HCV,high total cholesterol,high low density lipoprotein,and low high density lipoprotein on the risks of hyperglycemia.Conclusion The prevalence of hyperglycemia among antiretroviral-naive HIV-infected individuals is slightly higher than that in general population in Shenzhen.The classical factors including elder,overweight,obesity,high triglycerides,and opportunistic infections are the main risk factors of hyperglycemia.This study suggests that it is essential to have the routine screening of hyperglycemia,especially for old patients with abnormalities of multi metabolism.