Changes in insulin sensitivity over time and associated factors in HIV-infected adolescents

Mitchell E. Geffner, Kunjal Patel, Denise L. Jacobson, Julia Wu, Tracie L Miller, Rohan Hazra, Mariana Gerschenson, Tanvi Sharma, Margarita Silio, Jennifer Jao, Jody K. Takemoto, Russell B. Van Dyke, Linda A. DImeglio

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To compare prevalence of insulin resistance between perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected adolescents (PHEU), determine incidence of and contributory factors to new and resolved cases of insulin resistance in PHIV+, and evaluate glucose metabolism. Design: Cross-sectional design for comparison of prevalence among PHIV+ and PHEU. Longitudinal design for incidence and resolution of insulin resistance among PHIV+ at risk for these outcomes. Methods: The source population was adolescents from pediatric HIV clinics in the United States and Puerto Rico participating in the Pediatric HIV/AIDS Cohort Study, an ongoing prospective cohort study designed to evaluate impact of HIV infection and its treatment on multiple domains in preadolescents and adolescents. Insulin resistance was assessed by homeostatic model assessment of insulin resistance. Those with incident insulin resistance underwent 2-h oral glucose tolerance test and HbA1c. Baseline demographic, metabolic, and HIV-specific variables were evaluated for association with incident or resolved insulin resistance. Results: Unadjusted prevalence of insulin resistance in PHIV+ was 27.3 versus 34.1% in PHEU. After adjustment for Tanner stage, age, sex, and race/ethnicity, there was no significant difference between groups. Factors positively associated with developing insulin resistance included female sex, higher BMI z score, and higher waist circumference; those associated with resolving insulin resistance included male sex and lower BMI z score. Conclusion: Prevalence of insulin resistance in PHIV+ and PHEU was substantially higher than that reported in HIV-uninfected nonoverweight youth, but similar to that in HIV-uninfected obese youth. Factors associated with incident or resolved insulin resistance among PHIV+ were similar to those reported in HIV-negative obese youth. However, a contributory role of HIV infection and/or its treatment to the incident risk of insulin resistance cannot be excluded.

Original languageEnglish (US)
Pages (from-to)613-622
Number of pages10
JournalAIDS
Volume32
Issue number5
DOIs
StatePublished - Mar 13 2018

Fingerprint

Insulin Resistance
HIV
HIV Infections
Cohort Studies
Pediatrics
Puerto Rico
Incidence
Waist Circumference
Glucose Tolerance Test
Acquired Immunodeficiency Syndrome
Demography
Prospective Studies
Glucose

Keywords

  • BMI
  • homeostatic model assessment of insulin resistance
  • insulin resistance
  • oral glucose tolerance test
  • waist circumference

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Geffner, M. E., Patel, K., Jacobson, D. L., Wu, J., Miller, T. L., Hazra, R., ... DImeglio, L. A. (2018). Changes in insulin sensitivity over time and associated factors in HIV-infected adolescents. AIDS, 32(5), 613-622. https://doi.org/10.1097/QAD.0000000000001731

Changes in insulin sensitivity over time and associated factors in HIV-infected adolescents. / Geffner, Mitchell E.; Patel, Kunjal; Jacobson, Denise L.; Wu, Julia; Miller, Tracie L; Hazra, Rohan; Gerschenson, Mariana; Sharma, Tanvi; Silio, Margarita; Jao, Jennifer; Takemoto, Jody K.; Van Dyke, Russell B.; DImeglio, Linda A.

In: AIDS, Vol. 32, No. 5, 13.03.2018, p. 613-622.

Research output: Contribution to journalArticle

Geffner, ME, Patel, K, Jacobson, DL, Wu, J, Miller, TL, Hazra, R, Gerschenson, M, Sharma, T, Silio, M, Jao, J, Takemoto, JK, Van Dyke, RB & DImeglio, LA 2018, 'Changes in insulin sensitivity over time and associated factors in HIV-infected adolescents', AIDS, vol. 32, no. 5, pp. 613-622. https://doi.org/10.1097/QAD.0000000000001731
Geffner ME, Patel K, Jacobson DL, Wu J, Miller TL, Hazra R et al. Changes in insulin sensitivity over time and associated factors in HIV-infected adolescents. AIDS. 2018 Mar 13;32(5):613-622. https://doi.org/10.1097/QAD.0000000000001731
Geffner, Mitchell E. ; Patel, Kunjal ; Jacobson, Denise L. ; Wu, Julia ; Miller, Tracie L ; Hazra, Rohan ; Gerschenson, Mariana ; Sharma, Tanvi ; Silio, Margarita ; Jao, Jennifer ; Takemoto, Jody K. ; Van Dyke, Russell B. ; DImeglio, Linda A. / Changes in insulin sensitivity over time and associated factors in HIV-infected adolescents. In: AIDS. 2018 ; Vol. 32, No. 5. pp. 613-622.
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abstract = "Objective: To compare prevalence of insulin resistance between perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected adolescents (PHEU), determine incidence of and contributory factors to new and resolved cases of insulin resistance in PHIV+, and evaluate glucose metabolism. Design: Cross-sectional design for comparison of prevalence among PHIV+ and PHEU. Longitudinal design for incidence and resolution of insulin resistance among PHIV+ at risk for these outcomes. Methods: The source population was adolescents from pediatric HIV clinics in the United States and Puerto Rico participating in the Pediatric HIV/AIDS Cohort Study, an ongoing prospective cohort study designed to evaluate impact of HIV infection and its treatment on multiple domains in preadolescents and adolescents. Insulin resistance was assessed by homeostatic model assessment of insulin resistance. Those with incident insulin resistance underwent 2-h oral glucose tolerance test and HbA1c. Baseline demographic, metabolic, and HIV-specific variables were evaluated for association with incident or resolved insulin resistance. Results: Unadjusted prevalence of insulin resistance in PHIV+ was 27.3 versus 34.1{\%} in PHEU. After adjustment for Tanner stage, age, sex, and race/ethnicity, there was no significant difference between groups. Factors positively associated with developing insulin resistance included female sex, higher BMI z score, and higher waist circumference; those associated with resolving insulin resistance included male sex and lower BMI z score. Conclusion: Prevalence of insulin resistance in PHIV+ and PHEU was substantially higher than that reported in HIV-uninfected nonoverweight youth, but similar to that in HIV-uninfected obese youth. Factors associated with incident or resolved insulin resistance among PHIV+ were similar to those reported in HIV-negative obese youth. However, a contributory role of HIV infection and/or its treatment to the incident risk of insulin resistance cannot be excluded.",
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AU - Patel, Kunjal

AU - Jacobson, Denise L.

AU - Wu, Julia

AU - Miller, Tracie L

AU - Hazra, Rohan

AU - Gerschenson, Mariana

AU - Sharma, Tanvi

AU - Silio, Margarita

AU - Jao, Jennifer

AU - Takemoto, Jody K.

AU - Van Dyke, Russell B.

AU - DImeglio, Linda A.

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N2 - Objective: To compare prevalence of insulin resistance between perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected adolescents (PHEU), determine incidence of and contributory factors to new and resolved cases of insulin resistance in PHIV+, and evaluate glucose metabolism. Design: Cross-sectional design for comparison of prevalence among PHIV+ and PHEU. Longitudinal design for incidence and resolution of insulin resistance among PHIV+ at risk for these outcomes. Methods: The source population was adolescents from pediatric HIV clinics in the United States and Puerto Rico participating in the Pediatric HIV/AIDS Cohort Study, an ongoing prospective cohort study designed to evaluate impact of HIV infection and its treatment on multiple domains in preadolescents and adolescents. Insulin resistance was assessed by homeostatic model assessment of insulin resistance. Those with incident insulin resistance underwent 2-h oral glucose tolerance test and HbA1c. Baseline demographic, metabolic, and HIV-specific variables were evaluated for association with incident or resolved insulin resistance. Results: Unadjusted prevalence of insulin resistance in PHIV+ was 27.3 versus 34.1% in PHEU. After adjustment for Tanner stage, age, sex, and race/ethnicity, there was no significant difference between groups. Factors positively associated with developing insulin resistance included female sex, higher BMI z score, and higher waist circumference; those associated with resolving insulin resistance included male sex and lower BMI z score. Conclusion: Prevalence of insulin resistance in PHIV+ and PHEU was substantially higher than that reported in HIV-uninfected nonoverweight youth, but similar to that in HIV-uninfected obese youth. Factors associated with incident or resolved insulin resistance among PHIV+ were similar to those reported in HIV-negative obese youth. However, a contributory role of HIV infection and/or its treatment to the incident risk of insulin resistance cannot be excluded.

AB - Objective: To compare prevalence of insulin resistance between perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected adolescents (PHEU), determine incidence of and contributory factors to new and resolved cases of insulin resistance in PHIV+, and evaluate glucose metabolism. Design: Cross-sectional design for comparison of prevalence among PHIV+ and PHEU. Longitudinal design for incidence and resolution of insulin resistance among PHIV+ at risk for these outcomes. Methods: The source population was adolescents from pediatric HIV clinics in the United States and Puerto Rico participating in the Pediatric HIV/AIDS Cohort Study, an ongoing prospective cohort study designed to evaluate impact of HIV infection and its treatment on multiple domains in preadolescents and adolescents. Insulin resistance was assessed by homeostatic model assessment of insulin resistance. Those with incident insulin resistance underwent 2-h oral glucose tolerance test and HbA1c. Baseline demographic, metabolic, and HIV-specific variables were evaluated for association with incident or resolved insulin resistance. Results: Unadjusted prevalence of insulin resistance in PHIV+ was 27.3 versus 34.1% in PHEU. After adjustment for Tanner stage, age, sex, and race/ethnicity, there was no significant difference between groups. Factors positively associated with developing insulin resistance included female sex, higher BMI z score, and higher waist circumference; those associated with resolving insulin resistance included male sex and lower BMI z score. Conclusion: Prevalence of insulin resistance in PHIV+ and PHEU was substantially higher than that reported in HIV-uninfected nonoverweight youth, but similar to that in HIV-uninfected obese youth. Factors associated with incident or resolved insulin resistance among PHIV+ were similar to those reported in HIV-negative obese youth. However, a contributory role of HIV infection and/or its treatment to the incident risk of insulin resistance cannot be excluded.

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KW - homeostatic model assessment of insulin resistance

KW - insulin resistance

KW - oral glucose tolerance test

KW - waist circumference

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