| 德宏傣族景颇族自治州接受抗病毒治疗的HIV/AIDS糖尿病累积发病率的研究 |
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| 引用本文： | 叶润华,石瑞紫,曹东冬,姚仕堂,唐仁海,高洁,项丽芬,杨跃诚,王继宝,丁盈盈,何纳,段松.德宏傣族景颇族自治州接受抗病毒治疗的HIV/AIDS糖尿病累积发病率的研究[J].中华疾病控制杂志,2022,26(12):1371-1378. |
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| 作者姓名： | 叶润华 石瑞紫 曹东冬 姚仕堂 唐仁海 高洁 项丽芬 杨跃诚 王继宝 丁盈盈 何纳 段松 |
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| 作者单位： | 1.78400 芒市，德宏傣族景颇族自治州疾病预防控制中心 |
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| 基金项目： | 国家科技重大专项2018ZX17021102-004 |
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| 摘 要： | 目的 探究德宏傣族景颇族自治州(简称德宏州)接受抗病毒治疗(antiretroviral therapy, ART)的HIV感染者和AIDS病人(简称HIV/AIDS) 糖尿病3年累积发病率及其危险因素。 方法 采用队列设计，于2017年7月―2018年6月招募接受ART的HIV/AIDS为研究对象，于2021年1月―2021年7月进行队列随访，采集静脉血检测糖化血红蛋白(hemoglobin A1c, HbA1c)。糖尿病判定标准为符合其中任意一项:HbA1c≥6.5%或最近1次FPG≥7.0 mmol/L。采用logistic回归分析模型分析糖尿病发病的影响因素。 结果 本次分析纳入3 647例基线未患糖尿病的HIV/AIDS，平均年龄为42(36, 49)岁，男性占比51.4%，抗HCV IgG阳性率为21.5%，HIV感染确证平均时间为12.1(9.3, 14.6)年，ART平均时间为9.3(7.6, 12.2)年。糖尿病3年累积发病率为6.0%，其中HbA1c≥6.5%发病率为2.5%，FPG≥ 7.0 mmol/L发病率为5.3%。多因素logistic回归分析模型分析显示，年龄≥50岁、男性、HCV合并感染、基线TG升高、基线HIV病毒载量≥50 copies/mL和基线ART药物含依非韦伦(efavirenz, EFV)与糖尿病发病均呈正相关(均有P＜0.05)。 结论 德宏州HIV/AIDS糖尿病累积发病率较高，应对该人群针对性采取综合防治措施，降低糖尿病累积发病风险。
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| 关 键 词： | 艾滋病病毒 糖尿病 累积发病率 影响因素 |
| 收稿时间： | 2021-11-09 |
Research on incident diabetes among HIV/AIDS receiving antiretroviral therapy in Dehong Dai and Jingpo Autonomous Prefecture |
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| Affiliation: | 1.Dehong Dai and Jingpo Autonomous Prefecture Center for Disease Control and Prevention, Mangshi 678400, China2.Department of Epidemiology, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China3.Dehong Dai and Jingpo Autonomous Prefecture People's Hospital, Mangshi 678400, China |
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| Abstract: | Objective To estimate the cumulative incidence and risk factors of diabetes among HIV/AIDS patients receiving antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture (Dehong), Yunnan Province. Methods HIV/AIDS patients without diabetes at baseline (Jul 2017 to Jun 2018) were followed from Jan. 2021 to June 2021. Data of participants were extracted from the National HIV/AIDS antiretroviral therapy database in China. All participants underwent hemoglobin A1c (HbA1c) testing. Diabetes was defined as follow-up HbA1c≥6.5% or the most recent FPG≥7.0 mmol/L. Logistic regression analysis was conducted to evaluate the risk factors of diabetes among HIV/AIDS patients. Results A total of 3 647 HIV/AIDS patients were included in this study, with 51.4% being male and median age of 42 (36, 49) years old. Anti-HCV antibodies were detected in 21.5% of participants. The median time since HIV diagnosis and duration on ART were 12.1 (9.3, 14.6) and 9.3 (7.6, 12.2) years, respectively. The 3-year cumulative incidence of diabetes, HbA1c≥6.5% and PFG≥ 7.0 mmol/L were 6.0%, 2.5% and 5.3%, respectively. Multivariate logistics regression analysis showed that baseline age of ≥50 years, male, HCV-coinfection, elevated TG at baseline, baseline HIV viral load of > 50 copies/ml, baseline use of efavirenz (EFV) were significantly associated with higher risk of incident diabetes. (All P < 0.05). Conclusions HIV/AIDS patients receiving ART in Dehong prefecture are at high risk of diabetes, underscoring needs of targeted prevention and intervention programs in this population. |
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