Age-specific abnormal glucose metabolism in HIV-positive people on antiviral therapy in China: a multicenter case-control study

Ann Med. 2025 Dec;57(1):2427910. doi: 10.1080/07853890.2024.2427910. Epub 2025 Jan 22.

Abstract

Background: Update, the link between HIV infection and abnormal glucose metabolism (AGM) is still unclear. This study aims to investigate the impact of HIV infection on AGM, including insulin resistance (IR), impaired fasting glucose (IFG), and diabetes mellitus (DM).

Methods: A multicenter case-control study was conducted in Zhejiang province, China. After matching, the study included 1030 people living with HIV (PLWH) and 1030 people living without HIV (PLWTH). The age-specific incidence of AGM was compared between the two groups. Poisson regression models were used to calculate the relative risk (RR) and its 95% confidence interval (CI) to assess the associations.

Results: Compared to PLWTH, PLWH had a higher rate of IR, IFG and DM, and a higher risk of developing IR (RR: 1.83; 95% CI: 1.60-2.10), IFG (RR: 3.87; 95% CI: 2.55-6.07), and DM (RR: 1.52; 95% CI: 1.09-2.12). In the 30-44 age group, the risk of IR, IFG, and DM was the highest, with RRs of 2.04 (95%CI: 1.69-2.48), 7.46 (95%CI: 2.91-25.27), and 1.88 (95%CI: 0.90-4.10). HIV acquisition and cART usage >5 years were associated with increased risks of DM.

Conclusion: HIV infection is associated with early onset and high prevalence of IR and IFG. Longer duration of HIV infection and cART usage increased the occurrence of DM. These findings contribute to a better understanding of age-specific AGM and the modified glucose monitor strategies in PLWH.

Keywords: AIDS; HIV; abnormal glucose metabolism; diabetes mellitus; impaired fasting glucose; insulin resistance.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antiviral Agents* / therapeutic use
  • Blood Glucose / metabolism
  • Case-Control Studies
  • China / epidemiology
  • Diabetes Mellitus* / epidemiology
  • Female
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Infections* / metabolism
  • Humans
  • Incidence
  • Insulin Resistance
  • Male
  • Middle Aged
  • Risk Factors

Substances

  • Blood Glucose
  • Antiviral Agents

Grants and funding

The work was supported by National Key Research and Development Program of China (Grant number 2021YFC2301900-2021YFC2301901); National Natural Science Foundation of China (Grant Numbers: U23A20496, 82173577, 81672005); the Mega-Project of National Science and Technology for the 13th Five-Year Plan of China (Grant Numbers: 2018ZX10715-014-002); the Zhejiang Province Vanguard Goose-Leading Initiative (2024C03216).