首页|HIV感染者抗反转录病毒治疗后发生高血糖的影响因素分析

HIV感染者抗反转录病毒治疗后发生高血糖的影响因素分析

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目的 探讨HIV感染者抗反转录病毒治疗(antiretroviral therapy,ART)后高血糖的发生率及其影响因素.方法 回顾性选取2016年5月至2021年5月首都医科大学附属北京佑安医院HIV感染者1 000例,根据ART后是否发生高血糖分为病例组(n=121)和对照组(n=879).采用多因素logistic回归分析HIV感染者ART后发生高血糖的影响因素,并建立风险因素预测模型.结果 1 000例HIV感染者中,男987例、女性13例;年龄19～81岁,平均(36.6±11.2)岁;HIV感染者ART后高血糖的发生率为12.10%.多因素logistic回归分析结果显示,年龄越大(OR=1.036,95%CI:1.013～1.442,P=0.002)、BMI越高(OR=1.208,95%CI:1.074～1.636,P＜0.001)、存在糖尿病家族史(OR=2.427,95%CI:2.287～2.725,P＜0.001)、周运动时间越短(OR=0.053,95%CI:0.003～0.095,P=0.016)、CD4+T淋巴细胞计数越低(OR=0.268,95%CI:0.035～0.486,P=0.018)的患者更容易发生高血糖.预测模型为logit(Y)=7.396+0.302×年龄+0.729×BMI+0.355×家族史-0.006×周运动时间-1.227×CD4+T淋巴细胞计数.ROC曲线分析结果显示,该模型预测HIV感染者ART后发生高血糖的AUC为0.927(95%CI:0.910～0.944,P＜0.001),灵敏度为0.8702,特异性为0.9533,阳性预测率为0.9022,阴性预测率为0.9351.结论 HIV感染者ART后高血糖的发生率较高,年龄、BMI、家族史是HIV感染者ART后发生高血糖的独立危险因素;周运动时间及CD4+T淋巴细胞计数为其独立保护因素.构建的风险因素预测模型对HIV感染者ART后发生高血糖的预测价值较高.
Analysis of influencing factors of hyperglycemia in HIV-infected patients after antiretroviral therapy
Objective To explore the incidence of hyperglycemia and its influencing factors in HIV-infected patients after antiretroviral therapy(ART).Methods A total of 1 000 HIV-infected individuals in Beijing You'an Hospital,Capital Medical University from May 2016 to May 2021 were selected and divided into case group(n=121)and control group(n=879)based on whether hyperglycemia occurred after ART.The influencing factors of hyperglycemia in HIV-infected individuals after ART was analyzed by multivariate logistic regression,and a risk factor prediction model was established.Results Among the 1 000 HIV-infected patients,there were 987 males and 13 females,aged from 19 to 81 years,with an average of(36.6±11.2)years.The incidence of hyperglycemia after ART in HIV-infected individuals was 12.10%.The multivariate logistic regression analysis results showed that older age(OR=1.036,95%CI:1.013-1.442,P=0.002),higher BMI(OR=1.208,95%CI:1.074-1.636,P<0.001),family history of diabetes(OR=2.427,95%CI:2.287-2.725,P<0.001),shorter weekly exercise time(OR=0.053,95%CI:0.003-0.095,P=0.016),and lower CD4+T lymphocyte count(OR=0.268,95%CI:0.035-0.486,P=0.018)were associated with a higher likelihood of hyperglycemia.The prediction model was logit(Y)=7.396+0.302×age+0.729×BMI+0.355×family history-0.006×weekly exercise time-1.227×CD4+.The ROC curve analysis showed that the AUC for predicting hyperglycemia after ART in HIV-infected individuals was 0.927(95%CI:0.910-0.944,P<0.001),with a sensitivity of 0.8702,specificity of 0.9533,positive predictive value of 0.9022,and negative predictive value of 0.9351.Conclusions The incidence of hyperglycemia after ART in HIV-infected patients is high,of which age,BMI,and family history are independent risk factors,while weekly exercise time and CD4+T lymphocyte count are independent protective factors.The constructed risk factor prediction model has higher predictive value for hyperglycemia occurrence after ART in HIV-infected patients.

HIV-infected patientsantiretroviral therapy(ART)hyperglycemiainfluence factorpredictive value

吴冬霞、常可意、武秀连、韩佳凝、全晓丽、吕雪、胡景贤、刘洋、马建红

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100069 首都医科大学附属北京佑安医院感染与免疫医学科

100069 首都医科大学附属北京佑安医院护理部

HIV感染者 抗反转录病毒治疗 高血糖 影响因素 预测价值

2024

10.15932/j.0253-9713.2024.10.001

北京医学
中华医学会北京分会

北京医学

CSTPCD
影响因子：0.714
ISSN：0253-9713
年,卷(期)：2024.46(10)