ABSTRACT
BACKGROUND: Although diabetes is more common in HIV patients, the direct link between HIV and diabetes is unknown. Glucose abnormalities should be assessed among antiretroviral treatment (ART)-naive patients to reduce confounding by ART. We assessed diabetes status, insulin function and association with inflammation among Ethiopian ART-naive HIV patients. METHODS: Among HIV patients initiating ART, we used glycosylated hemoglobin (HbA1c) and oral glucose tolerance test (OGTT) to define prediabetes and diabetes. Insulin during OGTT was determined to calculate insulin function, and C-reactive protein and α1-acid glycoprotein were used as same-day markers of inflammation. RESULTS: Among 332 HIV patients, mean (SD) age was 32.9 (8.8) years, and 222 (66.9%) were women. None had known diabetes, but we found diabetes prevalence using OGTT and HbA1c to be 7.6 and 8.5%, respectively. C-reactive protein and α1-acid glycoprotein were positively associated with hyperglycemia and insulin deficiency, but not insulin resistance. We found poor correlation between traditional risk factors (age and anthropometry) and diabetes, but participants generally had low BMI and waist circumference. CONCLUSION: ART-naive Ethiopian HIV patients had a high prevalence of prediabetes and diabetes, with a poor agreement between HbA1c and OGTT. Diabetes was associated with inflammation, but not with adiposity and age. Diabetes was linked to insulin deficiency, rather than insulin resistance, which may represent a different entity than type 1 and 2 diabetes. This has implications for choice of drugs, when managing diabetes in African HIV patients.
Subject(s)
HIV Infections/complications , Hyperglycemia/epidemiology , Inflammation/epidemiology , Insulin/metabolism , Adult , Anti-Retroviral Agents/therapeutic use , C-Reactive Protein/analysis , Cross-Sectional Studies , Diabetes Mellitus/epidemiology , Ethiopia/epidemiology , Female , Glucose Tolerance Test , Glycated Hemoglobin/analysis , HIV Infections/drug therapy , Humans , Male , Middle Aged , Orosomucoid/analysis , Prevalence , Risk FactorsABSTRACT
BACKGROUND AND OBJECTIVES: Mola (Amblypharyngodon mola) is a nutrient-rich, small fish found in ponds and rice fields in Bangladesh. The aim of the present intervention was to assess the effect of mola consumption on iron status in children with marginal vitamin A status. METHODS AND STUDY DESIGN: Bangladeshi children (n=196), aged 3-7 years, with marginal vitamin A status were randomly allocated to one of three intervention groups served different fish curries: mola curry (experimental group); rui (Labeo rohita) curry with added retinyl palmitate (positive control group); or rui curry (negative control group). The intervention meals were served 6 days/week for 9 weeks. The experimental and positive control meals were designed to contain similar amounts of retinol activity equivalents per portion. The mola curry contained four times more iron compared to the rui curries due to different iron content in the two fish species. Haemoglobin, ferritin, serum transferrin receptor and Creactive protein were measured at screening and endpoint. RESULTS: In the experimental group receiving mola, serum transferrin receptor concentration declined 0.73 mg/L (95% CI 0.17, 1.28, p=0.01) compared to the positive control group, while there were no differences between groups in ferritin or haemoglobin. CONCLUSIONS: Consumption of mola instead of rui has potentially an effect on iron status in children with marginal vitamin A status, seen as a decrease in serum transferrin receptor concentration.
