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Is there sufficient evidence for a causal association between Antiretroviral therapy and Diabetes in HIV-infected patients? A meta-analysis
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Nduka, Chidozie U., Stranges, Saverio, Kimani, Peter K., Sarki, Ahmed M. and Uthman, Olalekan A. (2017) Is there sufficient evidence for a causal association between Antiretroviral therapy and Diabetes in HIV-infected patients? A meta-analysis. Diabetes/Metabolism Research and Reviews, 33 (6). e2902. doi:10.1002/dmrr.2902 ISSN 1520-7560.
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Official URL: http://doi.org/10.1002/dmrr.2902
Abstract
The association of antiretroviral therapy (ART) with diabetes is inconsistent and varies widely across primary epidemiological studies. A comprehensive and more precise estimate of this association is fundamental to establishing a plausible causal link between ART and diabetes. We identified epidemiological studies that compared mean fasting plasma glucose (FPG) concentrations and proportions of diabetes and metabolic syndrome between HIV-infected patients naïve and exposed to ART. Mean difference (MD) in FPG concentrations and odds ratios (OR) of diabetes and metabolic syndrome were pooled using random-effects meta-analyses. Data on 20,178 participants from 41 observational studies were included in the meta-analyses. Mean FPG concentrations (Pooled MD: 4.66 mg/dl, 95% confidence interval [CI] 2.52 to 6.80, 24 studies) and the odds of diabetes (Pooled OR: 3.85, 95% CI 2.93 to 5.07, 10 studies) and metabolic syndrome (Pooled OR: 1.45, 95% CI 1.03 to 2.03, 18 studies) were significantly higher among ART-exposed patients, compared to their naïve counterparts. ART was also associated with significant increases in FPG levels in studies with mean ART duration ≥ 18 months (Pooled MD: 4.97 mg/dl, 95% CI 3.10 to 6.84, 14 studies), but not in studies with mean ART duration < 18 months (Pooled MD: 4.40 mg/dl, 95% CI -0.59 to 9.38, 7 studies). ART may potentially be the single most consistent determinant of diabetes in people living with HIV worldwide. However, given the preponderance of cross-sectional studies in the meta-analysis, the association between ART and diabetes cannot be interpreted as cause and effect. [Abstract copyright: This article is protected by copyright. All rights reserved.]
| Item Type: | Journal Article | ||||||||
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||||
| Journal or Publication Title: | Diabetes/Metabolism Research and Reviews | ||||||||
| Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||||
| ISSN: | 1520-7560 | ||||||||
| Official Date: | September 2017 | ||||||||
| Dates: |
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| Volume: | 33 | ||||||||
| Number: | 6 | ||||||||
| Article Number: | e2902 | ||||||||
| DOI: | 10.1002/dmrr.2902 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Reuse Statement (publisher, data, author rights): | ** From PubMed via Jisc Publications Router. ** History: ** received: 28-04-2016 ** revised: 03-02-2017 ** accepted: 28-03-2017 | ||||||||
| Access rights to Published version: | Restricted or Subscription Access |
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