Insulin resistance and associated factors among HIV-infected patients in sub-Saharan Africa: a cross sectional study from Cameroon
Steve Raoul Ngongang Noumegni1,2,&, Jobert Richie Nansseu3, Vicky Jocelyne Ama Moor4,5, Jean Joel Bigna2,6, Felix Kembe Assah3, Magellan Guewo-Fokeng7,8, Steve Leumi7,8, Jean-Claude Katte9, Mesmin Dehayem9, Andre Pascal Kengne10,11, Eugene Sobngwi8,9,12
1Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364 Yaoundé, Cameroon, 2Faculty of Medicine, University of Paris Sud XI, 63 Av Gabriel Péri, Le Kremlin Bicêtre, France, 3Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon, 4Department of Biochemistry and Physiological Sciences, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon, 5Laboratory of Biochemistry, University Teaching Hospital, Yaoundé, Cameroon, 6Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, PO Box 1274, Yaoundé, Cameroon, 7Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon, 8Laboratory of Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, Yaoundé, Cameroon, 9National Obesity Center, Yaoundé Central Hospital, PO Box 87 Yaoundé, Cameroon, 10Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa, 11Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town 8000, South Africa, 12Departement of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon
Steve Raoul Ngongang Noumegni, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364 Yaoundé, Cameroon, Faculty of Medicine, University of Paris Sud XI, 63 Av Gabriel Péri, Le Kremlin Bicêtre, France
little is known on the magnitude and correlates of insulin resistance in HIV-infected people in Africa. We determined the prevalence of insulin resistance and investigated associated factors in HIV-infected adult Cameroonians.
we conducted a cross-sectional studyat the Yaoundé Central Hospital, Cameroon; during which we enrolled HIV-infected people aged 30 to 74 years with no previous history of cardiovascular disease. The homeostatic model assessment of insulin resistance (HOMA-IR) index served to assess insulin sensitivity with insulin resistance defined by values of 2.1 or higher.
we included 452 patients (20% men). Their mean age was 44.4 ± 9.8 years and 88.5% of them were on antiretroviral therapy (93.3% on first line regimen including Zidovudine, lamivudine and Efavirenz/Nevirapine). Of all participants, 28.5% were overweight, 19.5% had obesity and 2.0% had diabetes. The prevalence of insulin resistance was 47.3% without any difference between patients on ART and those ART-naïve (48.5% vs. 38.5%; p = 0.480). Obesity was the only factor independently associated with insulin resistance (adjusted odds ratio: 2.28; 95% confidence interval: 1.10-4.72).
insulin resistance is present in nearly half of HIV-infected patients in Cameroon despite a low prevalence rate of diabetes, and is associated with obesity.
The 3rd Africa Diabetes Congress, Yaounde, Cameroon (Yaounde)