Insulin resistance and associated factors among HIV-infected patients in sub-Saharan Africa: a cross sectional study from Cameroon

Lipids Health Dis. 2017 Aug 10;16(1):148. doi: 10.1186/s12944-017-0543-1.

Abstract

Background: Little is known on the magnitude and correlates of insulin resistance in HIV-infected people in Africa. We determined the prevalence of insulin resistance and investigated associated factors in HIV-infected adult Cameroonians.

Methods: We conducted a cross-sectional study at the Yaoundé Central Hospital, Cameroon; during which we enrolled HIV-infected people aged 30 to 74 years with no previous history of cardiovascular disease. An homeostatic model assessment of insulin resistance (HOMA-IR) like index served to assess insulin sensitivity with insulin resistance defined by values of 2.1 or higher.

Results: We included 452 patients (20% men). Their mean age was 44.4 ± 9.8 years and 88.5% of them were on antiretroviral therapy (93.3% on first line regimen including Zidovudine, lamivudine and Efavirenz/Nevirapine). Of all participants, 28.5% were overweight, 19.5% had obesity and 2.0% had diabetes. The prevalence of insulin resistance was 47.3% without any difference between patients on ART and those ART-naïve (48.5% vs. 38.5%; p = 0.480). Obesity was the only factor independently associated with insulin resistance (adjusted odds ratio: 2.28; 95% confidence interval: 1.10-4.72).

Conclusion: Insulin resistance is present in nearly half of HIV-infected patients in Cameroon despite a low prevalence rate of diabetes, and is associated with obesity.

Keywords: Cameroon; HIV; HOMA-IR; Insulin resistance.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Cameroon / epidemiology
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / epidemiology
  • Female
  • HIV Infections / blood*
  • HIV Infections / complications
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • Humans
  • Insulin Resistance*
  • Male
  • Middle Aged
  • Obesity / blood*
  • Obesity / complications
  • Obesity / drug therapy
  • Obesity / epidemiology
  • Odds Ratio
  • Prevalence
  • Risk Factors
  • Triglycerides / blood

Substances

  • Anti-HIV Agents
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides