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. 2022 Jul;16(7):102551.
doi: 10.1016/j.dsx.2022.102551. Epub 2022 Jun 18.

Inflammatory profile associated with insulin resistance in non-overweight versus overweight people living with HIV in Pune, Western India

Puja Chebrolu  1 , Shashikala Sangle  2 , Smita Nimkar  3 , Sonali Salvi  2 , Amol Chavan  3 , Vandana Kulkarni  3 , Dhananjay Shere  3 , Prasad Deshpande  3 , Todd T Brown  4 , Jyoti S Mathad  5 , Ivan Marbaniang  6 , Vidya Mave  3
Affiliations

Inflammatory profile associated with insulin resistance in non-overweight versus overweight people living with HIV in Pune, Western India

Puja Chebrolu et al. Diabetes Metab Syndr. 2022 Jul.

Abstract

Background: People living with HIV have greater diabetes (T2DM) than the general population despite lower prevalence of overweight/obesity. Both insulin resistance (IR), a T2DM precursor, and HIV are independently associated with chronic inflammation. Inflammation may be a pathophysiological link explaining IR in people living with HIV who are not overweight but is not well understood.

Aims: To study the association between inflammation and IR in non-overweight and overweight people living with HIV.

Methods: In a cohort of adult people living with HIV with undetectable viral load in Pune, India, we measured fasting insulin, glucose, and 9 inflammatory markers. IR was defined as HOMA-IR ≥2, and non-overweight as BMI ≤23 kg/m2. We used modified Poisson regression to evaluate the association between inflammatory markers and IR in overweight and non-overweight.

Results: Of 288 participants, 66% (n = 189) were non-overweight. Among non-overweight, prevalence of IR was 34% (n = 65). Each doubling of MCP-1 and leptin was associated with IR on univariate analysis (prevalence ratio (PR) 1.29, 95%CI 1.07-1.53, p < 0.01; PR 1.13 95%CI 1.01-1.26, p = 0.03). Leptin remained associated with IR after adjustment for age, MCP-1, gender, cholesterol, and waist circumference (adjusted PR 1.20 95%CI 1.06-1.36, p < 0.01). Among overweight, prevalence of IR was 69% and no markers were associated with IR.

Conclusions: One in 3 non-overweight people living with HIV in India with controlled viremia have IR. Leptin was associated with IR among non-overweight people living with HIV and may provide insight into the pathophysiology of metabolic disease in this population.

Keywords: HIV; Inflammation; Insulin resistance; Non-overweight.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Baseline inflammatory markers by insulin sensitivity status in PLWH with undetectable viral load by weight group. Green markers indicate levels of inflammatory markers in insulin sensitive (IS) participants. Red markers indicate levels of inflammatory markers in insulin resistant (IR) participants. Horizontal black lines indicate median values. Among non-overweight participants, median hsCRP level, median MCP-1 level, and median leptin level were higher among participants with IR than IS (p = 0.051, p = 0.01, and p = 0.06, respectively). Among overweight participants, PAI-1 was higher in participants with IR than with IS (p = 0.06).
Fig. 2.
Fig. 2.
MCP-1 and leptin stratified by underweight, normal weight, and overweight groups. Green markers indicate levels of inflammatory markers in insulin sensitive (IS) participants. Red markers indicate levels of inflammatory markers in insulin resistant (IR) participants. Horizontal black lines indicate median values. Among underweight participants only, MCP-1 and leptin were higher in IR compared to IS participants (p < 0.01 and p = 0.05, respectively).
See this image and copyright information in PMC

References

    1. Diabetes facts & figures. International Diabetes Federation; 2020. https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html. [Accessed 12 February 2020].
    1. Duncan AD, Goff LM, Peters BS. Type 2 diabetes prevalence and its risk factors in HIV: a cross-sectional study. PLoS One 2018;13(3):e0194199. 10.1371/journal.pone.0194199. - DOI - PMC - PubMed
    1. Samaras K, Gan SK, Peake PW, Carr A, Campbell LV. Proinflammatory markers, insulin sensitivity, and cardiometabolic risk factors in treated HIV infection. Obesity (Silver Spring) Jan 2009;17(1):53–9. 10.1038/oby.2008.500. - DOI - PubMed
    1. Brown TT, Cole SR, Li X, et al. Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the multicenter AIDS cohort study. Arch Intern Med May 2005;165(10):1179–84. 10.1001/archinte.165.10.1179. - DOI - PubMed
    1. Hanttu A, Kauppinen KJ, Kivelä P, et al. Prevalence of obesity and disturbances in glucose homeostasis in HIV-infected subjects and general population -missed diagnoses of diabetes? HIV Med Nov 2020. 10.1111/hiv.13009. - DOI - PMC - PubMed