High prevalence of impaired glucose metabolism among children and adolescents living with HIV in Ghana

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES HIV Medicine Pub Date : 2024-01-19 DOI:10.1111/hiv.13614

Ruth Ayanful-Torgby, Veronika Shabanova, Akosua A. Essuman, Emmanuel Boafo, Frank Aboagye, Yusuf Al-Mahroof, Jones Amponsah, John K. A. Tetteh, Linda E. Amoah, Elijah Paintsil

{"title":"High prevalence of impaired glucose metabolism among children and adolescents living with HIV in Ghana","authors":"Ruth Ayanful-Torgby, Veronika Shabanova, Akosua A. Essuman, Emmanuel Boafo, Frank Aboagye, Yusuf Al-Mahroof, Jones Amponsah, John K. A. Tetteh, Linda E. Amoah, Elijah Paintsil","doi":"10.1111/hiv.13614","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Antiretroviral therapy (ART)-associated metabolic abnormalities, including impairment of glucose metabolism, are prevalent in adults living with HIV. However, the prevalence and pathogenesis of impaired glucose metabolism in children and adolescents living with HIV, particularly in sub-Saharan Africa, are not well characterized. We investigated the prevalence of impaired glucose metabolism among children and adolescents living with perinatally infected HIV in Ghana.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this multicentre, cross-sectional study, we recruited participants from 10 paediatric antiretroviral treatment clinics from January to June 2022 in 10 facilities in Greater Accra and Eastern regions of Ghana. We determined impaired glucose metabolism in the study sample by assessing fasting blood sugar (FBS), insulin resistance as defined by the homeostatic model assessment for insulin resistance (HOMA-IR) index and glycated haemoglobin (HbA1c) levels. The prevalence of impaired glucose metabolism using each criterion was stratified by age and sex. The phenotypic correlates of glucose metabolism markers were also assessed among age, sex, body mass index (BMI) and waist-to-hip ratio (WHR).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We analysed data from 393 children and adolescents living with HIV aged 6–18 years. A little over half (205/393 or 52.25%) of the children were female. The mean age of the participants was 11.60 years (SD = 3.50), with 122/393 (31.00%) aged 6–9 years, 207/393 (52.67%) aged 10–15 years, and 62/393 (15.78%) aged 16–18 years. The prevalence rates of glucose impairment in the study population were 15.52% [95% confidence interval (CI): 12.26–19.45], 22.39% (95% CI: 18.54–26.78), and 26.21% (95% CI: 22.10–30.78) using HbA1c, HOMA-IR, and FBS criteria, respectively. Impaired glucose metabolism detected by FBS and HOMA-IR was higher in the older age group, whereas the prevalence of abnormal HbA1c levels was highest among the youngest age group. Age and BMI were positively associated with FBS and HOMA-IR (<i>p</i> < 0.001). However, there was negative correlation of WHR with HOMA-IR (<i>p</i> < 0.01) and HbA1c (<i>p</i> = 0.01).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The high prevalence of impaired glucose metabolism observed among the children and adolescents living with HIV in sub-Saharan Africa is of concern as this could contribute to the development of metabolic syndrome in adulthood.</p>\n </section>\n </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIV Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hiv.13614","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Antiretroviral therapy (ART)-associated metabolic abnormalities, including impairment of glucose metabolism, are prevalent in adults living with HIV. However, the prevalence and pathogenesis of impaired glucose metabolism in children and adolescents living with HIV, particularly in sub-Saharan Africa, are not well characterized. We investigated the prevalence of impaired glucose metabolism among children and adolescents living with perinatally infected HIV in Ghana.

Methods

In this multicentre, cross-sectional study, we recruited participants from 10 paediatric antiretroviral treatment clinics from January to June 2022 in 10 facilities in Greater Accra and Eastern regions of Ghana. We determined impaired glucose metabolism in the study sample by assessing fasting blood sugar (FBS), insulin resistance as defined by the homeostatic model assessment for insulin resistance (HOMA-IR) index and glycated haemoglobin (HbA1c) levels. The prevalence of impaired glucose metabolism using each criterion was stratified by age and sex. The phenotypic correlates of glucose metabolism markers were also assessed among age, sex, body mass index (BMI) and waist-to-hip ratio (WHR).

Results

We analysed data from 393 children and adolescents living with HIV aged 6–18 years. A little over half (205/393 or 52.25%) of the children were female. The mean age of the participants was 11.60 years (SD = 3.50), with 122/393 (31.00%) aged 6–9 years, 207/393 (52.67%) aged 10–15 years, and 62/393 (15.78%) aged 16–18 years. The prevalence rates of glucose impairment in the study population were 15.52% [95% confidence interval (CI): 12.26–19.45], 22.39% (95% CI: 18.54–26.78), and 26.21% (95% CI: 22.10–30.78) using HbA1c, HOMA-IR, and FBS criteria, respectively. Impaired glucose metabolism detected by FBS and HOMA-IR was higher in the older age group, whereas the prevalence of abnormal HbA1c levels was highest among the youngest age group. Age and BMI were positively associated with FBS and HOMA-IR (p < 0.001). However, there was negative correlation of WHR with HOMA-IR (p < 0.01) and HbA1c (p = 0.01).

Conclusion

The high prevalence of impaired glucose metabolism observed among the children and adolescents living with HIV in sub-Saharan Africa is of concern as this could contribute to the development of metabolic syndrome in adulthood.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

加纳感染艾滋病毒的儿童和青少年中糖代谢受损的发病率很高。

背景：与抗逆转录病毒疗法（ART）相关的代谢异常，包括糖代谢障碍，在成年 HIV 感染者中十分普遍。然而，在儿童和青少年艾滋病病毒感染者中，尤其是在撒哈拉以南非洲地区，糖代谢受损的发病率和发病机制尚不十分明确。我们调查了加纳围产期感染艾滋病毒的儿童和青少年中糖代谢受损的发病率：在这项多中心横断面研究中，我们于 2022 年 1 月至 6 月在加纳大阿克拉和东部地区的 10 个机构的 10 个儿科抗逆转录病毒治疗诊所招募了参与者。我们通过评估空腹血糖 (FBS)、胰岛素抵抗（根据胰岛素抵抗的稳态模型评估 (HOMA-IR) 指数和糖化血红蛋白 (HbA1c) 水平定义）来确定研究样本中糖代谢受损的情况。根据年龄和性别对每种标准下糖代谢受损的发生率进行了分层。我们还评估了糖代谢指标在年龄、性别、体重指数（BMI）和腰臀比（WHR）之间的表型相关性：我们分析了 393 名 6-18 岁感染艾滋病毒的儿童和青少年的数据。女性略高于半数（205/393 或 52.25%）。参与者的平均年龄为 11.60 岁（SD = 3.50），其中 122/393 人（31.00%）的年龄在 6-9 岁之间，207/393 人（52.67%）的年龄在 10-15 岁之间，62/393 人（15.78%）的年龄在 16-18 岁之间。根据 HbA1c、HOMA-IR 和 FBS 标准，研究人群中糖代谢障碍的患病率分别为 15.52% [95% 置信区间 (CI)：12.26-19.45]、22.39% (95% CI：18.54-26.78) 和 26.21% (95% CI：22.10-30.78)。通过 FBS 和 HOMA-IR 检测到的糖代谢受损在年龄较大的人群中发生率较高，而 HbA1c 水平异常在年龄最小的人群中发生率最高。年龄和体重指数与 FBS 和 HOMA-IR 呈正相关（p 结论：年龄和体重指数与 FBS 和 HOMA-IR 呈正相关：在撒哈拉以南非洲地区感染艾滋病毒的儿童和青少年中，发现糖代谢受损的发生率很高，这令人担忧，因为这可能会导致成年后出现代谢综合征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.