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. 2022 Mar 1;36(3):383-389.
doi: 10.1097/QAD.0000000000003127.

Sex differences in type 2 diabetes mellitus prevalence among persons with HIV

Morgan Birabaharan  1 , Andrew Strunk  2 , David C Kaelber  3   4 , Davey M Smith  1   5 , Thomas C S Martin  1   5
Affiliations

Sex differences in type 2 diabetes mellitus prevalence among persons with HIV

Morgan Birabaharan et al. AIDS. .

Abstract

Objective: To examine whether type 2 diabetes mellitus (T2DM) is more common among women with HIV (WWH) than men with HIV (MWH).

Design: A cross-sectional analysis of a demographically heterogenous population-based sample of more than 64 million patients in the United States.

Methods: Using the Explorys (IBM) database, compare the prevalence of T2DM among men and women without HIV and influence of HIV on T2DM by sex controlling for confounding factors.

Results: From 19 182 775 persons included in the study, 39 485 were with HIV. Rates of obesity was higher among WWH than MWH (58 vs. 35%). Prevalence of T2DM among WWH was 23% compared with 16% among MWH (P < 0.001). In sex-stratified adjusted analysis, WWH had 1.31 [95% confidence interval (CI), 1.24-1.38] times the odds of having T2DM than women without HIV. Women with HIV was associated with T2DM across all demographic subgroups. In contrast, no association between HIV and T2DM was observed among men (OR 1.01; 95% CI 0.98-1.05).

Conclusion: These data suggest that HIV confers a sex-specific increase in odds of T2DM among women but not men.

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Conflict of interest statement

Conflict of Interest: None to disclose.

Figures

Figure 1
Figure 1. Sex Differences in Type 2 Diabetes Mellitus Prevalence.
Proportion of persons with T2DM stratified by HIV serostatus, age and sex indicating increased prevalence among WWH compared to men without HIV. Abbreviations: T2DM – type 2 diabetes mellitus; WWH – women with HIV, NS - non-significant; *** denotes p<0.001 Statistical significance was set at P<.01
Figure 2
Figure 2. Sex Differences in the Association of Type 2 Diabetes Mellitus Among Persons with HIV.
Representation of sex-stratified odds of T2DM among persons with HIV. The odds ratio compares the odds of T2DM among WWH compared to women without HIV vs MWH compared to men without HIV. Odds were calculated based on a multivariable logistic regression analysis after controlling for age, race, obesity, smoking, hypertension, and hyperlipidemia. Interaction p-value refers to the null hypothesis that the strength of relationship between HIV and T2DM does not differ among sex. Abbreviations: aOR - adjusted odds ratio; T2DM – type 2 diabetes mellitus; WWH -women with HIV; MWH-men with HIV
Figure 3
Figure 3. Type 2 Diabetes Mellitus Among Women with HIV.
Representation of subgroup odds for T2DM among WWH. The odds ratio compares the odds of T2DM between women with and without HIV within subgroups (i.e women 18-44 years of age with HIV were 31% more likely to have T2DM than women 18-44 years of age without HIV after controlling for all confounding variables). They were calculated based on a multivariable logistic regression analysis after controlling for age, race, obesity, smoking, hypertension, and hyperlipidemia. Abbreviations: aOR - adjusted odds ratio; T2DM – type 2 diabetes mellitus; WWH -women with HIV; y-years. Statistical significance was set at P<.01
Figure 4
Figure 4. Type 2 Diabetes Mellitus Among Men with HIV.
Representation of subgroup odds for T2DM among MWH. The odds ratio compares the odds of T2DM between men with and without HIV within subgroups (i.e men 18-44 years of age with HIV were 11% less likely to have T2DM than men 18-44 years of age without HIV after controlling for all confounding variables). They were calculated based on a multivariable logistic regression analysis after controlling for age, race, obesity, smoking, hypertension, and hyperlipidemia. Abbreviations: aOR - adjusted odds ratio; T2DM – type 2 diabetes mellitus; MWH -men with HIV; y-years. Statistical significance was set at P<.01
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