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BMI as a predictor of high fasting blood glucose among people living with HIV in the Asia-Pacific region

Khuon D 1 , Rupasinghe D 2 , Saphonn V 3 , Kwong TS 4 , Widhani A 5 , Chaiwarith R 6 Show all authors , Ly PS 7 , Do CD 8 , Avihingsanon A 9 , Khusuwan S 10 , Merati TP 11 , Van Nguyen K 12 , Kumarasamy N 13 , Chan YJ 14 , Azwa I 15 , Ng OT 16 , Kiertiburanakul S 17 , Tanuma J 18 , Pujari S 19 , Ditangco R 20 , Zhang F 21 , Choi JY 22 , Gani Y 23 , Sangle S 24 , Ross J 25 , Gorbach PM 1 , Jiamsakul A 2 , IeDEA Asia-Pacific

Affiliations 

  • 1 Department of Epidemiology, University of California, Los Angeles, Los Angeles, California, USA
  • 2 Biostatistics Department, The Kirby Institute, UNSW Sydney, Kensington, Australia
  • 3 Department of Public Health, University of Health Sciences, Phnom Penh, Cambodia
  • 4 Infectious Disease Department, Queen Elizabeth Hospital, Hong Kong, China
  • 5 Internal Medicine Department, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
  • 6 Internal Medicine Department, Chiang Mai University - Research Institute for Health Sciences, Chiang Mai, Thailand
  • 7 National Center for HIV/AIDS, Dermatology and STDs, Phnom Penh, Cambodia
  • 8 Infectious Diseases Department, Bach Mai Hospital, Hanoi, Vietnam
  • 9 HIV-NAT/ Thai Red Cross AIDS Research Centre and Tuberculosis research unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 10 Medicine Department, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
  • 11 Internal Medicine Department, Faculty of Medicine Udayana University and Sanglah Hospital, Bali, Indonesia
  • 12 Department of Infectious Diseases Epidemiology, National Hospital for Tropical Diseases, Hanoi, Vietnam
  • 13 Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), VHS-Infectious Diseases Medical Centre, VHS, Chennai, India
  • 14 Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  • 15 University Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 16 Tan Tock Seng Hospital, National Centre for Infectious Diseases, Singapore
  • 17 Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 18 AIDS Medical Information Department, National Center for Global Health and Medicine, Tokyo, Japan
  • 19 Institute of Infectious Diseases, Pune, India
  • 20 Department of Internal Medicine, Research Institute for Tropical Medicine, Muntinlupa, Philippines
  • 21 Beijing Ditan Hospital, Capital Medical University, Beijing, China
  • 22 Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
  • 23 Hospital Sungai Buloh, Sungai Buloh, Malaysia
  • 24 Department of Medicine, BJ Government Medical College and Sassoon General Hospitals, Pune, India
  • 25 TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
HIV Med, 2023 Feb;24(2):139-152.
PMID: 35748404 DOI: 10.1111/hiv.13351

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 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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