Case-control study of diabetes mellitus in HIV-infected patients.

BACKGROUND

Diabetes mellitus (DM) is more prevalent among patients with HIV infection. Besides protease inhibitors (PIs), other factors may contribute to the development of DM.

OBJECTIVE

To assess characteristics associated with the development of DM in HIV-infected persons.

METHODS

We conducted a case-control study in an urban HIV clinic among patients with incident DM (49 cases) matched to 2 controls (n = 98) on age +/-5 years, race, sex, and length of clinic follow-up. There was a second set of unmatched controls (n = 196).

RESULTS

Compared with matched controls, case patients had higher mean body mass index (BMI; 30.0 vs. 25.3 kg/m, matched odds ratio [OR] = 1.20; P < 0.001), higher alanine aminotransferase (ALT; 66 vs. 44 U/L, OR = 1.12 per 10 U/L; P = 0.013), and stronger family history of DM (50% vs. 29%, OR = 3.30; P = 0.009). Hepatitic C virus coinfection and PI use were not significant factors. In unmatched controls, there was no significant difference in age, sex, or ethnicity. In multivariate analyses, BMI (OR = 1.13 per kg/m; P = 0.012), family history (OR = 5.55; P = 0.014), and ALT (OR = 1.16; P = 0.012) were associated with DM.

CONCLUSION

These findings suggest a complex interaction among genetic factors, body composition, and liver injury in the pathogenesis of DM in HIV-infected patients.