Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART.

Abstract

OBJECTIVES:

Our primary aim was to study diabetes mellitus (DM) arising during combination ART (cART) and to attempt to identify associations between these cases and triglycerides (TRG) and the TRG to HDL-cholesterol (TRG/HDL) ratio. Our secondary aim was to analyse the association between DM development and hepatic fibrosis.

METHODS:

This was a retrospective cohort study. Patients from the Icona Foundation study initiating first-line cART between 1997 and 2013 were selected and observed until new-onset DM or most recent clinical follow-up. The predictive value of TRG and TRG/HDL ratio levels on DM was evaluated using multivariable Poisson regression models.

RESULTS:

Three-thousand, five-hundred and forty-six patients (males, 73.7%; median age, 38 years; median BMI, 23.1 kg/m(2); and hepatitis C virus antibody positive, 22.1%) were included. Of these, 80 developed DM over 13 911 person-years of follow-up (PYFU), corresponding to 5.7 cases per 1000 PYFU (95% CI = 4.6-7.1). At multivariable analysis, latest TRG/HDL ratio, when high, was associated with significant increases in DM risk [relative risk (RR) = 1.63; 95% CI = 1.32-2.01 per 10 points higher], while current TRG, in contrast, was associated with new-onset DM only at crude analysis. Advanced liver fibrosis (defined as fibrosis-4 index >3.25) was also shown to be an independent risk factor for DM (RR = 2.91; 95% CI = 1.10-7.72).

CONCLUSIONS:

High TRG/HDL ratio predicted risk of new-onset DM, independently of other traditional risk factors. Furthermore, our findings suggest that advanced hepatic fibrosis, estimated using the fibrosis-4 score, could provide an additional predictor for DM.

• Authors: Nicola Squillace, Patrizia Lorenzini, Giuseppe Lapadula, Alessandra Bandera, Alessandro Cozzi-Lepri, Stefano Rusconi, Massimo Puoti, Antonella Castagna, Andrea Antinori, Andrea Gori, Antonella d'Arminio Monforte, Icona Foundation Study Group
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 71 Issue 9 Pg. 2663-9 (09 2016) ISSN: 1460-2091 [Electronic] England
• PMID: 27272727 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: [email protected].

Chemical References

• Anti-Retroviral Agents
• HDL-triglyceride
• Hepatitis C Antibodies
• Lipoproteins, HDL
• Triglycerides

Topics

• Adult
• Anti-Retroviral Agents (adverse effects, therapeutic use)
• Antiretroviral Therapy, Highly Active (adverse effects)
• Diabetes Mellitus (epidemiology)
• Female
• HIV Infections (complications, drug therapy)
• Hepatitis C Antibodies (blood)
• Humans
• Lipoproteins, HDL (blood)
• Liver Cirrhosis (complications)
• Male
• Middle Aged
• Retrospective Studies
• Risk Assessment
• Triglycerides (blood)