抗病毒治疗的HIV/AIDS病例高血糖的影响因素分析

Factors affecting hyperglycemia among HIV/AIDS patients receiving antiretroviral therapy

目的分析宁波市接受抗病毒治疗的艾滋病病毒感染者和艾滋病患者(HIV/AIDS)高血糖的影响因素。方法通过宁波市艾滋病抗病毒治疗数据库收集2005—2021年宁波市接受抗病毒治疗的HIV/AIDS病例资料,包括人口学信息、艾滋病抗病毒治疗情况和空腹血糖等资料。分析接受抗病毒治疗的HIV/AIDS病例空腹血糖水平,并采用多因素logistic回归模型分析高血糖的影响因素。结果纳入HIV/AIDS病例2607例,年龄为(45.16±13.93)岁,男性2162例,占82.93%;抗病毒治疗HIV感染时间M(QR)为5.00(5.00)年。高血糖589例,高血糖率为22.59%;其中空腹血糖受损355例,空腹血糖受损率为13.62%;糖尿病234例,患病率为8.98%。多因素logistic回归分析结果显示,性别(男性,OR=1.482,95%CI:1.120~1.961)、年龄(30岁~,OR=2.062,95%CI:1.356~3.137;45岁~,OR=3.697,95%CI:2.435~5.611;≥60岁,OR=7.295,95%CI:4.722~11.268)、WHO HIV感染临床分期(Ⅱ期,OR=1.415,95%CI:1.097~1.824;Ⅲ期,OR=1.571,95%CI:1.139~2.168;Ⅳ期,OR=1.488,95%CI:1.040~2.128)、HIV感染时间(7~<10年,OR=1.336,95%CI:1.004~1.777)、抗病毒治疗方案(二线方案,OR=0.611,95%CI:0.472~0.792)、血脂(单纯高TG,OR=1.665,95%CI:1.307~2.123;单纯高TC,OR=1.415,95%CI:1.006~1.991;血脂异常,OR=2.597,95%CI:1.971~3.422)与高血糖存在统计学关联。结论宁波市抗病毒治疗的HIV/AIDS病例高血糖发生率为22.59%;高血糖的发生与性别、年龄、HIV感染临床分期、HIV感染时间、治疗方案和血脂水平有关。

Objective To investigate the factors of hyperglycemia among HIV/AIDS patients receiving antiretroviral thera⁃py(ART)in Ningbo City.Methods The demographic characteristics,ART and fasting blood glucose were collected from HIV/AIDS patients receiving ART in Ningbo City from 2005 to 2021 through the Ningbo Municipal ART Data⁃base.The fasting blood glucose levels were analyzed among HIV/AIDS patients receiving ART,and the factors affecting hyperglycemia were identified using a multivariable logistic regression model.Results A total of 2607 HIV/AIDS pa⁃tients were enrolled,including 2162 men(82.93%),and the participants had a mean age of(45.16±13.93)years,and had mean ART duration of 5.00 years(interquartile range,5.00 years).The prevalence of hyperglycemia,impaired fast⁃ing glucose and diabetes was 22.59%,13.62% and 8.98%,respectively.Multivariable logistic regression analysis showed that gender(male,OR=1.482,95%CI:1.120-1.961),age(30 years-,OR=2.062,95%CI:1.356-3.137;45 years-,OR=3.697,95%CI:2.435-5.611;60 years and older,OR=7.295,95%CI:4.722-11.268),WHO clinical staging of HIV diseas⁃es(stageⅡ,OR=1.415,95%CI:1.097-1.824;stageⅢ,OR=1.571,95%CI:1.139-2.168;stageⅣ,OR=1.488,95%CI:1.040-2.128),duration of HIV infections(7 to<10 years,OR=1.336,95%CI:1.004-1.777),treatment regimen(second line regimen,OR=0.611,95%CI:0.472-0.792),and blood lipids(high TG,OR=1.665,95%CI:1.307-2.123;high TC,OR=1.415,95%CI:1.006-1.991;dyslipidemia,OR=2.597,95%CI:1.971-3.422)significantly correlated with hyperglycemia.Conclusions The overall prevalence of hyperglycemia was 22.59%among HIV/AIDS patients with ART in Ningbo City,and the prevalence of hyperglycemia correlated with gender,age,clinical staging of HIV infections,duration of HIV infections,treatment regimens and blood lipids among HIV/AIDS patients.