Effects of c ARV therapy on glucose metabolism,lipid metabolism and insulin resistance in AIDS patients
ZHANG Hongyan;YANG Dandan;ZHOU Qiwen;YANG Xinping;Infectious Department,Yunnan Provincial Infectious Disease Hospital;
Objective To investigate the effect of combined antiretroviral therapy( cARV) on glucose metabolism,lipid metabolism and insulin resistance in HIV/AIDS patients( HIV/AIDS). Methods From September 2007 to 2017 03 months with HIV/AIDS medical records,603 cases complete information were included in the study,comparative observation of insulin resistance in HIV/AIDS group and HIV negative group( IR) and analysis of influencing factors IR; dynamic observation of patients with HIV/AIDS before and after cARV treatment of blood lipids( triglycerides,total cholesterol to change). Results With the extension of cARV treatment time,the cumulative incidence of diabetes increased year by year. D4T,baseline blood glucose abnormality was a risk factor for the occurrence of diabetes,while NVP containing scheme had lower risk of diabetes than EFV containing scheme. The incidence of hypertriglyceridemia in the second-line group containing LPV/r was significantly higher than that in the first line group and the non cARV treatment group( t = 5. 17,P 0. 05),while there was no significant difference in the incidence of hypertriglyceridemia between the first line group and the cARV group without treatment( t = 0. 32,P 0. 05). The incidence of hypercholesterolemia in both the first line group and the second line group was significantly higher than that in the non cARV group( F = 8. 85,P 0. 05). Body mass index( BMI) = 23 kg/m~2( OR = 3. 81,95% CI: 1. 26-11. 47) are the risk factors of insulin resistance. Conclusion With diabetes risk factors of patients should avoid the use of D4T; for patients taking LPV/r should be monitored for blood lipids,hyperlipidemia should be appropriate; on BMI more than 23 kg/m~2 even in patients with normal fasting blood glucose,should also be monitoring of blood levels of insulin or oral glucose tolerance test.
【CateGory Index】： R512.91