Abstract
BackgroundLittle is known on the magnitude and correlates of insulin resistance in HIV-infected people in Africa. We determined the prevalence of insulin resistance and investigated associated factors in HIV-infected adult Cameroonians.MethodsWe conducted a cross-sectional study at the Yaoundé Central Hospital, Cameroon; during which we enrolled HIV-infected people aged 30 to 74 years with no previous history of cardiovascular disease. An homeostatic model assessment of insulin resistance (HOMA-IR) like index served to assess insulin sensitivity with insulin resistance defined by values of 2.1 or higher.ResultsWe included 452 patients (20% men). Their mean age was 44.4 ± 9.8 years and 88.5% of them were on antiretroviral therapy (93.3% on first line regimen including Zidovudine, lamivudine and Efavirenz/Nevirapine). Of all participants, 28.5% were overweight, 19.5% had obesity and 2.0% had diabetes. The prevalence of insulin resistance was 47.3% without any difference between patients on ART and those ART-naïve (48.5% vs. 38.5%; p = 0.480). Obesity was the only factor independently associated with insulin resistance (adjusted odds ratio: 2.28; 95% confidence interval: 1.10–4.72).ConclusionInsulin resistance is present in nearly half of HIV-infected patients in Cameroon despite a low prevalence rate of diabetes, and is associated with obesity.
Highlights
Little is known on the magnitude and correlates of insulin resistance in HIV-infected people in Africa
We considered as having diabetes any patient with at least 2 Fasting plasma glucose (FPG) levels ≥7.0 mmol/L on two occasions at least 48 h apart, or self-reported history of antidiabetic medications after the diagnosis was made in a health facility [14]
6.7% of participants were on second-line treatment, protease inhibitors containing regimen especially; no third line treatment was reported
Summary
Little is known on the magnitude and correlates of insulin resistance in HIV-infected people in Africa. Several studies have reported high prevalence of insulin resistance and other metabolic abnormalities in people living with HIV, including hypertriglyceridemia and low levels of high density lipoproteins (HDL-C). These metabolic abnormalities seem to be more preponderant among patients on ART, especially those on protease inhibitors-containing regimen [5, 6]. The present study was conducted to determine the prevalence of insulin resistance and associated factors among an HIV-infected African population
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