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Prevalence of type 2 diabetes mellitus and its predictive factors in Italy: a comparison between HIV-infected and uninfected subjects

  • L Galli1,
  • S Salpietro1,
  • G Pellicciotta2,
  • A Galliani3,
  • PM Piatti4,
  • H Hasson1,
  • M Guffanti1,
  • N Gianotti1,
  • A Bigoloni1,
  • A Lazzarin1 and
  • A Castagna1
Journal of the International AIDS Society201013(Suppl 4):P230

https://doi.org/10.1186/1758-2652-13-S4-P230

Published: 8 November 2010

Keywords

CholesterolBody Mass IndexDiabetes MellitusPredictive FactorObese Subject

Purpose of the study

We determined the prevalence of type-2 diabetes mellitus (DM) in HIV infected (HIV+) and uninfected (HIV-) subjects.

Methods

Cross-sectional analysis on HIV+ patients (pts), aged >18 years [median(IQR): 46(41-51)], who attended the Infectious Diseases Department of the San Raffaele Scientific Institute, alive or lost or dead after 2007 and HIV- subjects, healthy workers, aged >18 years [median(IQR): 47(40-53)], evaluated between 2007-2008, all over Italy (15 Italian regions), in a campaign for the assessment of cardiovascular risk factors, promoted by the Occupational Medicine of the H San Raffaele Resnati. Logistic regression used to determine the risk of DM; odds ratios(OR) and its 95% confidence intervals reported.

Results

4249 HIV+ (3248 males) and 9148 HIV- (7052 males) individuals. HIV+ pts had a higher prevalence of DM than HIV- [N=172 (4.1%) vs N=225 (2.5%), p<0.0001; OR=1.68 (1.37-2.05)]. Prevalence of DM was still higher among HIV+ than HIV- after controlling for body mass index (BMI) [<25: 3.2% vs 1.1%; 25-29.9: 2.9% vs 3.1%; >=30: 12.7% vs 7.8%; OR=1.79(1.29-2.50)], age [<=50 years old (yrs): 1.7% vs 1.2%; >50yrs: 10.8% vs 4.9%; OR=2.02(1.65-2.49)] or gender [Females: 2.7% vs 1.1%; Males: 4.5% vs 2.9%; OR=1.69(1.38-2.06)] or both factors [Females<=50yrs: 0.9% vs 0.8%; Females >50yrs: 11.1% vs 1.8%; Males<=50yrs: 2.0% vs 1.3%; Males>50yrs: 10.8% vs 5.6%; OR=2.02(1.64-2.48)].

Among subjects with DM, HIV+ pts were significantly different compared to HIV- as follows: were older(p<0.0001), had a lower BMI(p<0.0001), lower cholesterol(p<0.0001), lower HDL-cholesterol(p<0.0001), lower fasting glucose(p<0.0001) and higher triglycerides (p=0.019). HIV+ and HIV- pts with DM were similar with respect to LDL-cholesterol, systolic and diastolic pressure and smoking status. After adjustment for age (<=50yrs, >50yrs), gender, BMI (<25, 25-29.9, >=30), cholesterol, HDL- and LDL-cholesterol, triglycerides and hypertension (yes vs no), HIV+ pts had a higher risk of diabetes (OR=1.71(1.02-2.86), p=0.043). Increasing age [>50yrs vs <=50yrs: OR=4.10(3.01-5.59), p<0.0001] or BMI [25-29.9 vs <25: OR=1.87(1.28-2.74); >=30 vs <25: OR=4.67(3.08-7.10); overall effect: p<0.0001] were also predictive factors of a greater risk of DM.

Conclusions

Our findings suggest an increased prevalence of type-2 diabetes in HIV+ than HIV- subjects which was almost doubled in HIV+ than HIV- and up to 4-fold higher among obese subjects or those aged>50 years.

Authors’ Affiliations

(1)
San Raffaele Scientific Institute, Infectious Diseases, Milan, Italy
(2)
San Raffaele Scientific Institute, Occupational Health, Milan, Italy
(3)
H San Raffaele Resnati, Milan, Italy
(4)
Internal Medicine Department, San Raffaele Scientific Institute, Milan, Italy

Copyright

© Galli et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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