BMI as a predictor of high fasting blood glucose among people living with HIV in the Asia-Pacific region

Khuon, Dyna and Rupasinghe, Dhanushi and Saphonn, Vonthanak and Kwong, Tsz-Shan and Widhani, Alvina and Chaiwarith, Romanee and Ly, Penh Sun and Do, Cuong Duy and Avihingsanon, Anchalee and Khusuwan, Suwimon and Merati, Tuti Parwati and Nguyen, Kinh Van and Kumarasamy, Nagalingeswaran and Chan, Yu-Jiun and Azwa, Iskandar and Ng, Oon Tek and Kiertiburanakul, Sasisopin and Tanuma, Junko and Pujari, Sanjay and Ditangco, Rossana and Zhang, Fujie and Choi, Jun Yong and Gani, Yasmin and Sangle, Shashikala and Ross, Jeremy and Gorbach, Pamina M. and Jiamsakul, Awachana and Asia-Pacific, IeDEA (2023) BMI as a predictor of high fasting blood glucose among people living with HIV in the Asia-Pacific region. HIV Medicine, 24 (2). pp. 139-152. ISSN 1464-2662, DOI

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Background Non-Asian body mass index (BMI) classifications are commonly used as a risk factor for high fasting blood glucose (FBG). We investigated the incidence and factors associated with high FBG among people living with HIV in the Asia-Pacific region, using a World Health Organization BMI classification specific to Asian populations. Methods This study included people living with HIV enrolled in a longitudinal cohort study from 2003 to 2019, receiving antiretroviral therapy (ART), and without prior tuberculosis. BMI at ART initiation was categorized using Asian BMI classifications: underweight (<18.5 kg/m(2)), normal (18.5-22.9 kg/m(2)), overweight (23-24.9 kg/m(2)), and obese (>= 25 kg/m(2)). High FBG was defined as a single post-ART FBG measurement >= 126 mg/dL. Factors associated with high FBG were analyzed using Cox regression models stratified by site. Results A total of 3939 people living with HIV (63% male) were included. In total, 50% had a BMI in the normal weight range, 23% were underweight, 13% were overweight, and 14% were obese. Median age at ART initiation was 34 years (interquartile range 29-41). Overall, 8% had a high FBG, with an incidence rate of 1.14 per 100 person-years. Factors associated with an increased hazard of high FBG included being obese (>= 25 kg/m(2)) compared with normal weight (hazard ratio HR] = 1.79; 95% confidence interval CI] 1.31-2.44; p < 0.001) and older age compared with those aged <= 30 years (31-40 years: HR = 1.47; 95% CI 1.08-2.01; 41-50 years: HR = 2.03; 95% CI 1.42-2.90; >= 51 years: HR = 3.19; 95% CI 2.17-4.69; p < 0.001). Conclusion People living with HIV with BMI >25 kg/m(2) were at increased risk of high FBG. This indicates that regular assessments should be performed in those with high BMI, irrespective of the classification used.

Item Type: Article
Funders: Fogarty UCLA/Cambodia, United States Department of Health & Human Services National Institutes of Health (NIH) - USA
Uncontrolled Keywords: Asia-Pacific; BMI; High fasting blood glucose; HIV
Subjects: R Medicine
Divisions: Faculty of Medicine > Medicine Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 13 Jul 2023 04:16
Last Modified: 13 Jul 2023 04:16

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