International Journal of Diabetes in Developing Countries

, Volume 32, Issue 3, pp 145–150

Cardiometabolic risk, insulin resistance and immunity in HIV/AIDS patients receiving highly active retroviral therapy

  • Kofoworola Awotedu
  • Benjamin Longo-Mbenza
  • John Sungwacha Nasila
  • Abolade Awotedu
  • Chukwuma Ekpebegh
Original Article

DOI: 10.1007/s13410-012-0082-2

Cite this article as:
Awotedu, K., Longo-Mbenza, B., Nasila, J.S. et al. Int J Diabetes Dev Ctries (2012) 32: 145. doi:10.1007/s13410-012-0082-2
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Abstract

Prior to the advent of HAART (Highly Active retroviral therapy), studies of insulin resistance in HIV infection showed normal insulin sensitivity. The metabolic disturbances due to HAART are now reported in our setting. To investigate potential associations between cardiometabolic indices, innate and adaptive immunity, adipokines, and markers of insulin resistance (IR) in HIV/AIDS patients on first-line antiretroviral therapy (ART) were studied. This cross-sectional study selected HIV/AIDS patients treated with ART at public clinics of Mthatha Municipality, South Africa. Age, waist-to-hip ratio, blood pressure, total cholesterol (TC), HDL-C, LDL-C, triglycerides, C-peptide, uric acid, C-reactive protein (CRP), glucose, and albuminuria were the cardiometabolic indices. Innate immunity (lymphocytes), adaptive immunity (CD4 cell count), adipokines (adiponectin, leptin), and insulin resistance markers—fasting serum Insulin and homeostasis model assessment—IR score were also explored. Out of 258 selected patients, aged 38.1 ± 9.3 years, 79.5 % were females. There was a univariate correlation between HOMA-IR score and triglyceride (r = 0.331; P < 0.0001), uric acid (r = 0.386; P = 0.008), albuminuria (r = 0.316; P < 0.0001), adiponectin (r = −0.322; P = 0.035), lymphocytes (r = 0.186; P = 0.04) and waist-to-hip ratio (r = 0.217; P = 0.013), and HOMA-IR score. C-peptide was correlated with serum Insulin (r = 0.694; P < 0.0001). After adjusting for confounding factors, only triglycerides and C-Peptide independently and significantly explained 64.1 % of the variance in HOMA-IR score. Patients receiving ART are at higher risk for diabetes mellitus, cardiovascular disease and chronic renal disease. Regular monitoring of patients on first-line anti-retroviral agents is imperative to detect these cardiometabolic risk factors and allow for treatment to be initiated early.

Keywords

Insulin resistanceMetabolic syndromeDiabetesCardio-renal diseasesAntiretroviral therapy

Copyright information

© Research Society for Study of Diabetes in India 2012

Authors and Affiliations

  • Kofoworola Awotedu
    • 1
  • Benjamin Longo-Mbenza
    • 2
    • 4
  • John Sungwacha Nasila
    • 3
  • Abolade Awotedu
    • 2
  • Chukwuma Ekpebegh
    • 2
  1. 1.Department of PhysiologyFaculty of Health Sciences, Walter Sisulu UniversityMthathaSouth Africa
  2. 2.Department of Internal MedicineFaculty of Health Sciences, Walter Sisulu UniversityMthathaSouth Africa
  3. 3.Department of StatisticsWalter Sisulu UniversityMthathaSouth Africa
  4. 4.Walter Sisulu University, Faculty of Health SciencesMthathaSouth Africa