Association Between Systemic Inflammation and Incident Diabetes in HIV-Infected Patients After Initiation of Antiretroviral Therapy

• DOI: 10.2337/dc10-0633
• Publication Date: 2010-07-28T02:24:27Z
• Authors: Todd T. Brown; Katherine Tassiop...; Ronald J. Bosch; Cecilia Shikuma; Grace A. McComsey
• Keywords: Quartile

OBJECTIVE To determine whether systemic inflammation after initiation of HIV-antiretroviral therapy (ART) is associated with the development diabetes. RESEARCH DESIGN AND METHODS We conducted a nested case-control study, comparing 55 previously ART-naive individuals who developed diabetes 48 weeks ART (case subjects) did not develop during comparable follow-up (control subjects), matched on baseline BMI and race/ethnicity. Stored plasma samples at treatment (week 0) 1 year later 48) were assayed for levels high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), soluble receptors tumor necrosis factor-α (sTNFR1 sTNFR2). RESULTS Case subjects older than control (median age 41 vs. 37 years, P = 0.001), but groups otherwise comparable. Median all markers, except hs-CRP, decreased from week 0 to 48. Subjects higher sTNFR1, sTNFR2 had an increased odds subsequent diabetes, adjustment marker level, age, 48, CD4 count (< >200 cells/mm3), indinavir use (all Ptrend ≤ 0.05). After further glucose, effects attenuated only sTNFR1 remained significant (odds ratio, highest quartile lowest 23.2 [95% CI 1.28–423], 0.03). CONCLUSIONS Inflammatory markers risk These findings suggest that may contribute pathogenesis among HIV-infected patients.