期刊
HIV MEDICINE
卷 10, 期 2, 页码 72-78出版社
WILEY
DOI: 10.1111/j.1468-1293.2008.00653.x
关键词
antiretroviral therapy; c-peptide; homeostasis model assessment (HOMA); insulin; insulin resistance; lipodystrophy
资金
- Thailand Research Fund
- Royal Thai Government
- Johns Hopkins University
Background Highly active antiretroviral therapy ( HAART) is reported to cause insulin resistance among adults, but effects on children are less clear. We attempted to describe the prevalence of insulin resistance among HIV-infected children receiving HAART. Methods Insulin resistance was assessed at 96 weeks of treatment with nonnucleoside reverse transcriptase inhibitor (NNRTI)-based HAART (nevirapine or efavirenz with stavudine and lamivudine) among children in Chiang Mai, Thailand. Insulin resistance was defined as homeostasis model assessment for insulin resistance ( HOMA-IR) >= 3.16, fasting c-peptide >= 4.40 ng/mL or fasting insulin >= 25.0 mu U/mL. Impaired fasting glucose (IFG) was defined as glucose >= 110 mg/dL. Measurements were analysed for associations with age, lipodystrophy, treatment regimen and clinical data. Results The prevalence of insulin resistance was 6.5%; no child had IFG. Those with insulin resistance were older with higher body mass index. Children >= 10 years had higher IIOMA-IR, c-peptide and insulin, but no difference was seen in the frequency of insulin resistance. No associations between insulin resistance and lipodystrophy or treatment regimen were detected. Conclusions Insulin resistance is uncommon among children receiving NNRTI-based HAART and is unrelated to lipodystrophy.
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