Abstract
Background: Non-Asian body mass index (BMI) classifications are commonly used as a risk factor for high fasting blood glucose (FBG). We investigated the incidence and factors associated with high FBG among people living with HIV in the Asia-Pacific region, using a World Health Organization BMI classification specific to Asian populations. Methods: This study included people living with HIV enrolled in a longitudinal cohort study from 2003 to 2019, receiving antiretroviral therapy (ART), and without prior tuberculosis. BMI at ART initiation was categorized using Asian BMI classifications: underweight (<18.5 kg/m2), normal (18.5–22.9 kg/m2), overweight (23–24.9 kg/m2), and obese (≥25 kg/m2). High FBG was defined as a single post-ART FBG measurement ≥126 mg/dL. Factors associated with high FBG were analyzed using Cox regression models stratified by site. Results: A total of 3939 people living with HIV (63% male) were included. In total, 50% had a BMI in the normal weight range, 23% were underweight, 13% were overweight, and 14% were obese. Median age at ART initiation was 34 years (interquartile range 29–41). Overall, 8% had a high FBG, with an incidence rate of 1.14 per 100 person-years. Factors associated with an increased hazard of high FBG included being obese (≥25 kg/m2) compared with normal weight (hazard ratio [HR] = 1.79; 95% confidence interval [CI] 1.31–2.44; p < 0.001) and older age compared with those aged ≤30 years (31–40 years: HR = 1.47; 95% CI 1.08–2.01; 41–50 years: HR = 2.03; 95% CI 1.42–2.90; ≥51 years: HR = 3.19; 95% CI 2.17–4.69; p < 0.001). Conclusion: People living with HIV with BMI >25 kg/m2 were at increased risk of high FBG. This indicates that regular assessments should be performed in those with high BMI, irrespective of the classification used.
| Original language | English |
|---|---|
| Pages (from-to) | 139-152 |
| Number of pages | 14 |
| Journal | HIV Medicine |
| Volume | 24 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2023 Feb |
Bibliographical note
Funding Information:The study team would like to acknowledge all TAHOD study members, the steering committee, and the people living with HIV for their support. TAHOD study members: PS Ly*, V Khol, National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia; FJ Zhang*, HX Zhao, N Han, Beijing Ditan Hospital, Capital Medical University, Beijing, China; MP Lee*, PCK Li, TS Kwong, TH Li, Queen Elizabeth Hospital, Hong Kong SAR; N Kumarasamy*, C Ezhilarasi, Chennai Antiviral Research and Treatment Clinical Research Site (ART CRS), VHS-Infectious Diseases Medical Centre, VHS, Chennai, India; S Pujari*, K Joshi, S Gaikwad, A Chitalikar, Institute of Infectious Diseases, Pune, India; S Sangle*, V Mave, I Marbaniang, S Nimkar, BJ Government Medical College and Sassoon General Hospital, Pune, India; TP Merati*, DN Wirawan, F Yuliana, Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia; E Yunihastuti*, A Widhani, S Maria, TH Karjadi, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; J Tanuma*, S Oka, T Nishijima, National Center for Global Health and Medicine, Tokyo, Japan; JY Choi*, Na S, JM Kim, Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; YM Gani*, NB Rudi, Hospital Sungai Buloh, Sungai Buloh, Malaysia; I Azwa*, A Kamarulzaman, SF Syed Omar, S Ponnampalavanar, University Malaya Medical Centre, Kuala Lumpur, Malaysia; R Ditangco*, MK Pasayan, ML Mationg, Research Institute for Tropical Medicine, Muntinlupa City, Philippines; YJ Chan*, WW Ku, PC Wu, E Ke, Taipei Veterans General Hospital, Taipei, Taiwan; OT Ng*, PL Lim, LS Lee, T Yap, Tan Tock Seng Hospital, National Centre for Infectious Diseases, Singapore (note: OT Ng is also supported by the Singapore Ministry of Health‘s (MOH) National Medical Research Council (NMRC) Clinician Scientist Award (MOH-000276). Any opinions, findings and conclusions or recommendations expressed in this material are those of the author(s) and do not reflect the views of MOH/NMRC.); A Avihingsanon*, S Gatechompol, P Phanuphak, C Phadungphon, HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand; S Kiertiburanakul*, A Phuphuakrat, L Chumla, N Sanmeema, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; R Chaiwarith*, T Sirisanthana, J Praparattanapan, K Nuket, Chiang Mai University - Research Institute for Health Sciences, Chiang Mai, Thailand; S Khusuwan*, P Kantipong, P Kambua, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand; KV Nguyen*, HV Bui, DTH Nguyen, DT Nguyen, National Hospital for Tropical Diseases, Hanoi, Vietnam; CD Do*, AV Ngo, LT Nguyen, Bach Mai Hospital, Hanoi, Vietnam; AH Sohn*, JL Ross*, B Petersen, TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand; MG Law*, A Jiamsakul*, D Rupasinghe, The Kirby Institute, UNSW Sydney, NSW, Australia. * TAHOD Steering Committee member.
Funding Information:
YM Gani*, NB Rudi, Hospital Sungai Buloh, Sungai Buloh, Malaysia; I Azwa*, A Kamarulzaman, SF Syed Omar, S Ponnampalavanar, University Malaya Medical Centre, Kuala Lumpur, Malaysia; R Ditangco*, MK Pasayan, ML Mationg, Research Institute for Tropical Medicine, Muntinlupa City, Philippines; YJ Chan*, WW Ku, PC Wu, E Ke, Taipei Veterans General Hospital, Taipei, Taiwan; OT Ng*, PL Lim, LS Lee, T Yap, Tan Tock Seng Hospital, National Centre for Infectious Diseases, Singapore (note: OT Ng is also supported by the Singapore Ministry of Health‘s (MOH) National Medical Research Council (NMRC) Clinician Scientist Award (MOH‐000276). Any opinions, findings and conclusions or recommendations expressed in this material are those of the author(s) and do not reflect the views of MOH/NMRC.); A Avihingsanon*, S Gatechompol, P Phanuphak, C Phadungphon, HIV‐NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand; S Kiertiburanakul*, A Phuphuakrat, L Chumla, N Sanmeema, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; R Chaiwarith*, T Sirisanthana, J Praparattanapan, K Nuket, Chiang Mai University ‐ Research Institute for Health Sciences, Chiang Mai, Thailand; S Khusuwan*, P Kantipong, P Kambua, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand;
Publisher Copyright:
© 2022 British HIV Association.
All Science Journal Classification (ASJC) codes
- Health Policy
- Infectious Diseases
- Pharmacology (medical)
