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

Jing Sun, Todd T. Brown, Weiqun Tong, David Samuels, Phyllis Tien, Brahim Aissani, Bradley Aouizerat, Maria Villacres, Mark H. Kuniholm, Deborah Gustafson, Katherine Michel, Mardge Cohen, Michael Schneider, Adaora A. Adimora, Mohammed K. Ali, Hector Bolivar, Todd Hulgan

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)E218-E225
JournalClinical Infectious Diseases
Volume71
Issue number8
DOIs
StatePublished - Oct 15 2020

Keywords

  • aging
  • diabetes mellitus
  • HIV
  • mitochondrial genetics

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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