scholarly journals Metabolic Disorders in Patients with HIV

2016 ◽  
Vol 23 (4) ◽  
pp. 397-401
Author(s):  
Florentina Radu ◽  
Raluca Elena Jipa ◽  
Emilia Rusu ◽  
Raluca Cursaru ◽  
Ramona Drăguţ ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Human Immunodeficiency Virus ◽  
Cardiovascular Diseases ◽  
Metabolic Disorders ◽  
Bone Fractures ◽  
Chronic Renal Disease ◽  
Mortality Rates ◽  
Mortality And Morbidity ◽  
Immunodeficiency Virus

AbstractHuman Immunodeficiency Virus (HIV) infection and subsequent antiretroviral therapy (ART) are known to be related to different metabolic disorders. Although ART decreased HIV-associated mortality and morbidity, mortality rates in patients with HIV and ART are 3 to 15 higher than those in the general population. More than 50% of the mortality is due to diseases like: diabetes mellitus (DM), hypertension, cardiovascular diseases (CVD), chronic renal disease and complications following bone fractures. In patients with HIV the metabolic disorders are mainly caused by mithocondrial toxicity, a side effect of ART, and they are represented by: dyslipidemia, lipoatrophy, insulin resistance and diabetes mellitus.

scholarly journals African Mitochondrial DNA Haplogroup L2 Is Associated With Slower Decline of β-cell Function and Lower Incidence of Diabetes Mellitus in Non-Hispanic, Black Women Living With Human Immunodeficiency Virus

2020 ◽  
Vol 71 (8) ◽  
pp. e218-e225
Author(s):  
Jing Sun ◽  
Todd T Brown ◽  
Weiqun Tong ◽  
David Samuels ◽  
Phyllis Tien ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Human Immunodeficiency Virus ◽  
Mitochondrial Dna ◽  
Black Women ◽  
Cell Function ◽  
Β Cell ◽  
Immunodeficiency Virus ◽  
Β Cell Function ◽  
The Impact

Abstract Background Susceptibility to metabolic diseases may be influenced by mitochondrial genetic variability among people living with human immunodeficiency virus (HIV; PLWH), but remains unexplored in populations with African ancestry. We investigated the association between mitochondrial DNA (mtDNA) haplogroups and the homeostatic model assessments of β-cell function (HOMA-B) and insulin resistance (HOMA-IR), as well as incident diabetes mellitus (DM), among Black women living with or at risk for HIV. Methods Women without DM who had fasting glucose (FG) and insulin (FI) data for ≥2 visits were included. Haplogroups were inferred from genotyping data using HaploGrep. HOMA-B and HOMA-IR were calculated using FG and FI data. Incident DM was defined by a combination of FG ≥ 126 mg/dL, the use of DM medication, a DM diagnosis, or hemoglobin A1c ≥ 6.5%. We compared HOMA-B, HOMA-IR, and incident DM by haplogroups and assessed the associations between HOMA-B and HOMA-IR and DM by haplogroup. Results Of 1288 women (933 living with HIV and 355 living without HIV), PLWH had higher initial HOMA-B and HOMA-IR than people living without HIV. PLWH with haplogroup L2 had a slower decline in HOMA-B per year (Pinteraction = .02) and a lower risk of incident DM (hazard ratio [HR], 0.51; 95% confidence interval [CI], .32–.82) than PLWH with other haplogroups after adjustments for age, body mass index, combination antiretroviral therapy use, CD4 cell counts, and HIV RNA. The impact of HOMA-IR on incident DM was less significant in those with haplogroup L2, compared to non-L2 (HR, 1.28 [95% CI, .70–2.38] vs 4.13 [95% CI, 3.28–5.22], respectively; Pinteraction < .01), among PLWH. Conclusions Mitochondrial genetic variation is associated with β-cell functions and incident DM in non-Hispanic, Black women with HIV and alters the relationship between insulin resistance and DM.

scholarly journals POS0561 OBESITY PHENOTYPES IN EARLY RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 515.1-515
Author(s):  
Y. Gorbunova ◽  
T. Popkova ◽  
L. Kondrateva ◽  
M. Cherkasova ◽  
E. Nasonov ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Waist Circumference ◽  
Metabolic Disorders ◽  
Normal Weight ◽  
Atherogenic Index ◽  
World Health ◽  
Early Ra ◽  
Metabolically Healthy

Background:Patients with rheumatoid arthritis (RA) and obesity have a lower risk of early death than patients with normal weight due to the so-called “obesity paradox”. Available publications discuss three phenotypes of obesity: classical obesity, metabolically healthy overweight/obesity, and latent obesity (normal weight associated with metabolic disorders, most importantly - with insulin resistance and adipocytokines imbalance).Objectives:To clarify the prevalence of obesity phenotypes and to identify factors predisposing to «latent obesity» in early RA without diabetes mellitus or hyperglycemia.Methods:The study included 35 pts (23 women, 12 men) with early RA (criteria ACR / EULAR, 2010), 56 [43,0; 60,0] years old, naïve to treatment with glucocorticoids and disease-modifying anti-rheumatics, without established diabetes mellitus. Pts were seropositive for IgM RF and anti-CCP, with highly active RA (DAS28 5,9 [5,2; 6,4]; SDAI 35,4 [27,0; 45,8], and CDAI 31,0 [26,0; 44,0]) scores, and median disease duration of 8.0 [6,0;15.0] months. Electrochemiluminescence assay Elecsys (Roche Diagnostics) was used to measure patients’ insulin levels, and ELISA (DBS – Diagnostics Biochem Canada Inc.) - for evaluation of serum leptin concentrations. Insulin resistance (IR) was defined as Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR) ≥2,77. Leptin levels were considered elevated at values ≥11,1 ng/ml for women, ≥5,6 ng/ml for men. The overweight/obesity status was determined by World Health Organization criteria in pts with body mass index (BMI) ≥25kg/m2.Results:Overweight/obesity were documented in 19 (54, 3%) pts with early RA, 4/19 (21%) had high leptin levels and IR, 11/19 (58%) had isolated hyperleptinemia. Normal BMI was found in 16 (45,7%) pts with early RA, 2/16 (12,5%) had elevated leptin levels and IR, and 6/16 (37,5%) – only hyperleptinemia. Four (21%) out of 19 overweight and 8 (50%) out of 16 pts with normal BMI did not show any metabolic disorders (p=0,02). Сlassical obesity was found in 15 (43%), and latent obesity – in 8 (23%) pts with early RA. Leptin levels correlated with waist circumference (r=0,58, p=0,02), BMI (r=0,71, p=0,0006), ESR (r=0,5, p=0,02) in the overweight/obese pts, and with waist circumference (r=0,59, p=0,03), IgM RF (r=0,58, p=0,03), triglyceride levels (r=0,77, p=0,003), and atherogenic index (r=0,62, p=0,03) in pts with normal weight.Conclusion:The classical obesity phenotype associated with abdominal obesity and inflammation was the most common and prevailing over other phenotypes in early RA. Latent obesity was less common and was associated with an unfavorable lipid profile and accumulation of abdominal fat, therefore increasing the risk of cardiovascular diseases in RA. Metabolically healthy overweight/obesity in early RA was really a rare phenotype.Disclosure of Interests:None declared

Chronic Kidney Disease in Cameroon: A scoping review

2020 ◽  
Author(s):  
Jerry Brown Aseneh ◽  
Ben-Lawrence A. Kemah ◽  
Stephane Mabouna ◽  
Njang Mbeng Emmanuel ◽  
Domin Sone Majunda Ekane ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Human Immunodeficiency Virus ◽  
Kidney Disease ◽  
Scoping Review ◽  
Associated Factors ◽  
Treatment Cost ◽  
Advanced Age ◽  
High Morbidity ◽  
Immunodeficiency Virus

Abstract ObjectivesThis scoping review sought to summarize available data on the prevalence, associated factors, etiology, comorbidities, treatment, cost, and mortality of chronic kidney disease (CKD) in Cameroon.MethodsWe searched PubMed, Scopus and African Journals Online from database inception to 31 March, 2020 to identify all studies published on the prevalence, associated factors, etiology, comorbidities, treatment, cost and mortality of CKD in Cameroon.ResultsThirty studies were included. The population prevalence of CKD varied from 3-14.1% and 10.0%-14.2% in rural and urban areas, respectively. The prevalence of CKD in patients with hypertension, diabetes mellitus, and human immunodeficiency virus was 12.4-50.0%, 18.5%, and 3.0-47.2%, respectively. Hypertension (22.3-59.1%), chronic glomerulonephritis (15.8-56.2%), and diabetes mellitus (15.8-56.2%) were the most common causes of CKD. The cause was unknown in 13.5-17.0% of the cases. Advanced age, hypertension, diabetes mellitus, and obesity were frequent associated factors. Hemodialysis was the main treatment modality in patients with End Stage Renal Disease (ESRD). The monthly cost of management of non-dialyzed CKD was 163 US dollars. The one-year mortality rate of ESRD was 26.8-38.6%.ConclusionChronic kidney disease in affects about one in ten adults in the general population in Cameroon Patients with hypertension, diabetes mellitus, and human immunodeficiency virus bear the greatest burden of CKD in Cameroon. Advanced age, hypertension, diabetes mellitus, and obesity are major factors associated with CKD. Chronic kidney disease in Cameroon is associated with high morbidity and mortality and huge economic cost on the patient.

Obstetrics

2020 ◽  
pp. 1-103
Author(s):  
Charlotte Goumalatsou
Keyword(s):  
Diabetes Mellitus ◽  
Human Immunodeficiency Virus ◽  
Venous Thromboembolism ◽  
Connective Tissue ◽  
Cardiac Disease ◽  
Postnatal Care ◽  
Hyperemesis Gravidarum ◽  
Immunodeficiency Virus ◽  
Obstetric Emergencies ◽  
In Pregnancy

This chapter in the Oxford Handbook of Clinical Specialties describes the obstetrics specialty, including antenatal care and screening. Medical conditions in pregnancy are investigated, including hyperemesis gravidarum, sickle-cell disease, cardiac disease, psychiatry, epilepsy, anaemia, HIV (human immunodeficiency virus), diabetes mellitus, thyroid disease, jaundice, malaria, renal disease, respiratory disease, connective tissue disease, hypertension, thromboprophylaxis, thrombophilia, and venous thromboembolism. Antenatal problems are explored, leading on to a discussion of labour and delivery, postnatal care, and obstetric emergencies.

Differences by Sex in Cardiovascular Comorbid Conditions Among Older Adults (Aged 50–64 or ≥65 Years) Receiving Care for Human Immunodeficiency Virus

2019 ◽  
Vol 69 (12) ◽  
pp. 2091-2100 ◽  
Author(s):  
Emma L Frazier ◽  
Madeline Y Sutton ◽  
Yunfeng Tie ◽  
Jennifer Fagan ◽  
Robyn Neblett Fanfair
Keyword(s):  
Diabetes Mellitus ◽  
Human Immunodeficiency Virus ◽  
Total Cholesterol ◽  
Total Cholesterol Level ◽  
High Total Cholesterol ◽  
Medical Monitoring ◽  
Comorbid Conditions ◽  
Cholesterol Levels ◽  
Immunodeficiency Virus ◽  
Medical Monitoring Project

Abstract Background Differences by sex in cardiovascular comorbid conditions among human immunodeficiency virus (HIV)–infected persons aged 50–64 years have been understudied; even fewer data are available for persons aged ≥65 years. Methods We used matched interview and medical record abstraction data from the 2009–2012 data cycles of the Medical Monitoring Project, a nationally representative sample of HIV-infected adults in care. We included men and women aged 50–64 and ≥65 years at time of interview. We calculated weighted prevalence estimates and used logistic regression to compute adjusted prevalence differences and 95% confidence intervals (CIs) assessing sex differences in various characteristics and cardiovascular comorbid conditions. Comorbid conditions included overweight/obesity (body mass index ≥25), abnormal total cholesterol level (defined as ≥200 mg/dL), diagnosed diabetes mellitus, or diagnosed hypertension. Results Of 7436 participants, 89.5% were aged 50–64 years and 10.4% aged ≥65 years, 75.1% were men, 40.4% (95% CI, 33.5%–47.2%) were non-Hispanic black, 72.0% (70.4%–73.6%) had HIV infection diagnosed ≥10 years earlier. After adjustment for sociodemographic and behavioral factors, women aged 50–64 years were more likely than men to be obese (adjusted prevalence difference, 8.4; 95% CI, 4.4–12.3), have hypertension (3.9; .1–7.6), or have high total cholesterol levels (9.9; 6.2–13.6). Women aged ≥65 years had higher prevalences of diabetes mellitus and high total cholesterol levels than men. Conclusions Cardiovascular comorbid conditions were prevalent among older HIV-infected persons in care; disparities existed by sex. Closer monitoring and risk-reduction strategies for cardiovascular comorbid conditions are warranted for older HIV-infected persons, especially older women.

scholarly journals Frailty Is Associated With Insulin Resistance in Chronic Human Immunodeficiency Virus Infection

2019 ◽  
Vol 71 (4) ◽  
pp. 1127-1128
Author(s):  
Dominic C Chow ◽  
Monika Anna Bernas ◽  
Louie Mar Gangcuangco ◽  
Jason Huynh ◽  
Lindsay B Kohorn ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Immunodeficiency Virus
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