德宏傣族景颇族自治州抗病毒治疗的HIV/AIDS糖尿病患病率及其相关因素分析

摘要

目的 了解云南省德宏傣族景颇族自治州(德宏州)抗病毒治疗的HIV/AIDS糖尿病患病情况及其相关因素.方法 利用我国艾滋病防治基本信息系统下载德宏州HIV/AIDS抗病毒治疗数据库,并于2017年7月至2018年6月对德宏州≥18岁正在抗病毒治疗的HIV/AIDS开展横断面调查,并采集其静脉血检测其糖化血红蛋白(HbA1c).糖尿病判定标准为符合其中任意一项者(HbA1c≥6.5％、基线FPG≥7.0 mmol/L、最近1次FPG≥7.0 mmol/L).采用logistic回归分析抗病毒治疗的HIV/AIDS患有糖尿病的相关因素.结果 共纳入4 376例HIV/AIDS,年龄(43.7±10.1)岁,男性占53.8％(2 356/4376),HCV阳性率为24.1％(1 055/4376),HIV确诊阳性时间(8.9±3.8)年,治疗时间(6.8±2.9)年.糖尿病患病率为11.4％(500/4376).多因素logistic回归分析结果显示,抗病毒治疗的HIV/AIDS患糖尿病的相关危险因素包括≥40岁、男性、HCV阳性、基线BMI≥24.0 kg/m2、最近1次TG≥1.70 mmol/L、初始抗病毒治疗药物为依非韦伦(EFV).结论 德宏州抗病毒治疗的HIV/AIDS糖尿病患病率为11.4％.对于抗病毒治疗的HIV/AIDS,应加强中老年、男性、HCV阳性、超重和高TG等糖尿病相关危险因素的预防与控制工作,需进一步研究EFV与糖尿病患病风险的可能关联.%Objective To study the prevalence and correlates of diabetes among HIV/AIDS who were on antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefectures (Dehong),Yunnan province.Methods The database of HIV/AIDS receiving ART in Dehong was downloaded by using the basic information system of AIDS prevention and control in China.In this cross-sectional study,HIV/AIDS patients who were currently on ART and aged 18 years or above,were consecutively recruited,between July 2017 and June 2018,in Dehong.All the subjects underwent hemoglobin A1c (HbA1c) testing.Patient with diabetes was defined as meeting any of these indicators (HbA1c ≥6.5％,baseline FPG ≥7.0 mmol/L,FPG ≥7.0 mmol/L in the most recent visit).Both univariate and multivariate logistic regression analysis were carried on to evaluate the correlates of diabetes among the HIV/AIDS patients.Results In total of 4 376 HIV/AIDS patients were included for analysis,with the average age as (43.7 ± 10.1) years,proportion of males as 53.8％ (2 356/4 376) and the HCV positive rate as 24.1％ (1 055/4 376).The mean years was (8.94±3.8) years after the HIV diagnosis was made,and the mean duration on treatment was (6.8 ± 2.9) years.The prevalence of diabetes was 11.4％ (500/4 376).Through multivariate logistic regression analysis,data showed that the risk factors of diabetes of HIV/AIDS on ART were:aged 40 years or above,being male,HCV positive,baseline body mass index ≥24.0 kg/m2,elevated TG ≥ 1.70 mmol/L in the most recent visit and baseline antiretroviral regimens under Efavirenz (EFV).Conclusions Prevalence rate of diabetes appeared higher in HIV/AIDS patients who were on ART in Dehong.Prevention and control measures should be targeted on HIV/AIDS patients who were with risk factors of diabetes as being elderly,male,HCV positive,overweight and higher TG.Further esearch is needed to evaluate the association between the use of EFV and diabetes.