Factors associated with insulin resistance among children and adolescents perinatally infected with HIV-1 in the pediatric HIV/AIDS cohort study

Mitchell E. Geffner, Kunjal Patel, Tracie L. Miller, Rohan Hazra, Margarita Silio, Russell B. Van Dyke, William Borkowsky, Carol Worrell, Linda A. Dimeglio, Denise L. Jacobson

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Background/Aims: Because of prior inconsistent findings, we studied a large cohort of HIV-infected children to determine: (1) prevalence of insulin resistance (IR); (2) anthropometric and clinical correlates of IR, and (3) concomitant abnormalities of glucose tolerance. Methods: The study population consisted of 451 children from the Pediatric HIV/AIDS Cohort Study. The outcome of interest was HOMA-IR. Covariates included demographic, metabolic, growth, body composition, HIV laboratory tests, and treatment characteristics. Children meeting triggers for IR underwent oral glucose tolerance tests and hemoglobin A1c (HbA1c) measurements. Results: Among 402 children with glucose and insulin measurements, 15.2% had IR of whom 79% were pubertal. IR was associated with higher alanine aminotransferase, body mass index, and nadir CD4%, Tanner stage 5, and ever having received amprenavir. Of those with IR, three had impaired fasting glucose (IFG), three impaired glucose tolerance (IGT), one IFG and IGT, none diabetic glucose tolerance, and three HbA1c between 6.1 and 6.5%. Conclusion: In our cohort of HIV-infected adolescents, we observed a 15.2% prevalence of IR more closely linked to obesity than any other variable. This finding mirrors the high prevalence of obesity-mediated IR in American youth. However, associations with CD4 count and use of protease inhibitors may indicate some effect of HIV and/or its treatment.

Original languageEnglish (US)
Pages (from-to)386-391
Number of pages6
JournalHormone Research in Paediatrics
Volume76
Issue number6
DOIs
StatePublished - Dec 1 2011

Keywords

  • Highly active antiretroviral therapy
  • HIV
  • Homeostatic model assessment of insulin resistance
  • Insulin resistance

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Pediatrics, Perinatology, and Child Health

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    Geffner, M. E., Patel, K., Miller, T. L., Hazra, R., Silio, M., Van Dyke, R. B., Borkowsky, W., Worrell, C., Dimeglio, L. A., & Jacobson, D. L. (2011). Factors associated with insulin resistance among children and adolescents perinatally infected with HIV-1 in the pediatric HIV/AIDS cohort study. Hormone Research in Paediatrics, 76(6), 386-391. https://doi.org/10.1159/000332957