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. 2023 Feb;24(2):139-152.
doi: 10.1111/hiv.13351. Epub 2022 Jun 24.

BMI as a predictor of high fasting blood glucose among people living with HIV in the Asia-Pacific region

Dyna Khuon  1   2 , Dhanushi Rupasinghe  3 , Vonthanak Saphonn  2 , Tsz-Shan Kwong  4 , Alvina Widhani  5 , Romanee Chaiwarith  6 , Penh Sun Ly  7 , Cuong Duy Do  8 , Anchalee Avihingsanon  9 , Suwimon Khusuwan  10 , Tuti Parwati Merati  11 , Kinh Van Nguyen  12 , Nagalingeswaran Kumarasamy  13 , Yu-Jiun Chan  14 , Iskandar Azwa  15 , Oon Tek Ng  16 , Sasisopin Kiertiburanakul  17 , Junko Tanuma  18 , Sanjay Pujari  19 , Rossana Ditangco  20 , Fujie Zhang  21 , Jun Yong Choi  22 , Yasmin Gani  23 , Shashikala Sangle  24 , Jeremy Ross  25 , Pamina M Gorbach  1 , Awachana Jiamsakul  3 ; IeDEA Asia-Pacific
Affiliations

BMI as a predictor of high fasting blood glucose among people living with HIV in the Asia-Pacific region

Dyna Khuon et al. HIV Med. 2023 Feb.

Abstract

Background: Non-Asian body mass index (BMI) classifications are commonly used as a risk factor for high fasting blood glucose (FBG). We investigated the incidence and factors associated with high FBG among people living with HIV in the Asia-Pacific region, using a World Health Organization BMI classification specific to Asian populations.

Methods: This study included people living with HIV enrolled in a longitudinal cohort study from 2003 to 2019, receiving antiretroviral therapy (ART), and without prior tuberculosis. BMI at ART initiation was categorized using Asian BMI classifications: underweight (<18.5 kg/m2 ), normal (18.5-22.9 kg/m2 ), overweight (23-24.9 kg/m2 ), and obese (≥25 kg/m2 ). High FBG was defined as a single post-ART FBG measurement ≥126 mg/dL. Factors associated with high FBG were analyzed using Cox regression models stratified by site.

Results: A total of 3939 people living with HIV (63% male) were included. In total, 50% had a BMI in the normal weight range, 23% were underweight, 13% were overweight, and 14% were obese. Median age at ART initiation was 34 years (interquartile range 29-41). Overall, 8% had a high FBG, with an incidence rate of 1.14 per 100 person-years. Factors associated with an increased hazard of high FBG included being obese (≥25 kg/m2 ) compared with normal weight (hazard ratio [HR] = 1.79; 95% confidence interval [CI] 1.31-2.44; p < 0.001) and older age compared with those aged ≤30 years (31-40 years: HR = 1.47; 95% CI 1.08-2.01; 41-50 years: HR = 2.03; 95% CI 1.42-2.90; ≥51 years: HR = 3.19; 95% CI 2.17-4.69; p < 0.001).

Conclusion: People living with HIV with BMI >25 kg/m2 were at increased risk of high FBG. This indicates that regular assessments should be performed in those with high BMI, irrespective of the classification used.

Keywords: Asia-Pacific; BMI; HIV; high fasting blood glucose.

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Conflict of interest statement

Author Disclosure Statement

The authors have no conflict of interest to disclose.

Figures

Figure 1A:
Figure 1A:
Kalpan–Meier curves of PLHIV by Asian BMI classification
Figure 1B:
Figure 1B:
Kalpan–Meier curves of PLHIV by age group
See this image and copyright information in PMC

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