Glucose metabolism continuous deteriorating in male patients with human immunodeficiency virus accepted antiretroviral therapy for 156 weeks.

BACKGROUND: The dynamic characteristics of glucose metabolism and its risk factors in patients living with human immunodeficiency virus (PLWH) who accepted primary treatment with the efavirenz (EFV) plus lamivudine (3TC) plus tenofovir (TDF) (EFV + 3TC + TDF) regimen are unclear and warrant investigation. AIM: To study the long-term dynamic characteristics of glucose metabolism and its contributing factors in male PLWH who accepted primary treatment with the EFV + 3TC + TDF regimen for 156 wk. METHODS: This study was designed using a follow-up design. Sixty-one male treatment-naive PLWH, including 50 cases with normal glucose tolerance and 11 cases with prediabetes, were treated with the EFV + 3TC + TDF regimen for 156 wk. The glucose metabolism dynamic characteristics, the main risk factors and the differences among the three CD4+ count groups were analyzed. RESULTS: In treatment-naive male PLWH, regardless of whether glucose metabolism disorder was present at baseline, who accepted treatment with the EFV + 3TC + TDF regimen for 156 wk, a continuous increase in the fasting plasma glucose (FPG) level, the rate of impaired fasting glucose (IFG) and the glycosylated hemoglobin (HbA1c) level were found. These changes were not due to insulin resistance but rather to significantly reduced islet ß cell function, according to the homeostasis model assessment of ß cell function (HOMA-ß). Moreover, the lower the baseline CD4+ T-cell count was, the higher the FPG level and the lower the HOMA-ß value. Furthermore, the main risk factors for the FPG levels were the CD3+CD8+ cell count and viral load (VL), and the factors contributing to the HOMA-ß values were the alanine aminotransferase level, VL and CD3+CD8+ cell count. CONCLUSION: These findings provide guidance to clinicians who are monitoring FPG levels closely and are concerned about IFG and decreased islet ß cell function during antiretroviral therapy with the EFV + 3TC + TDF regimen for long-term application.

[Difference of Liver Enzymes in Different Metabolism States of Chronic Hepatitis B].

OBJECTIVE: To analyze the difference of liver enzymes in different metabolism state groups of chronic hepatitis B (CHB). METHODS: We use prospective cross-sectional study to analyze the difference of liver enzymes in different metabolism state groups in 110 cases of CHB, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and glutamyl transferase (GGT). RESULTS: Regardless of the presence or absence of fatty liver, the levels of ALP and GGT were increased along with the deterioration of glucose metabolism (P<0.05).The levels of ALP and GGT in the presence of fatty liver group were higher than those in the absence of fatty liver group (P<0.05). The levels of AST, ALP and GGT showed the trend of increasing along with the increase of HOMA-IR and the decrease of HOMA-ß. There was no difference of liver enzymes among the groups with or without other metabolism disorder (P>0.05). CONCLUSION: In CHB, abnormal glucose metabolism and fatty liver can lead to the increase of ALP and GGT. The increase of HOMA-IR and the decrease of HOMA-ß may lead to the increase of AST, ALP and GGT. Other metabolism disorder did not show any effect on the level of liver enzymes.

[Predicting visceral and abdominal subcutaneous adipose areas with anthropometric parameters in Chinese male patients with type 2 diabetes].

OBJECTIVE: To predict the abdominal subcutaneous adipose area (SA) and visceral adipose area (VA) with simple anthropometric parameters in Chinese male patients with type 2 diabetes. METHODS: The SA and VA were measured by Computed Tomography (CT) in 91 Chinese male patients with type 2 diabetes. The anthropometric parameters used in predicting the SA and VA included weight (W), height (H), body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist to hip ratio (WHR). The multiple stepwise regression analysis was undertaken in a randomly selected sample with 77 subjects (80% of total subjects) to establish predictive equations between the SA or VA and the anthropometric parameters. The equations were then cross-validated in the remaining 14 subjects (20% of total subjects) that had not been included in the regression analysis. RESULTS: The BMI and WC entered into the final predictive equation for the SA, while the BMI remained to be the only variable for predicting the SA. The differences between the predicted values and the observed values were 2.06% and 4.34% for the VA and SA respectively. CONCLUSION: The VA and SA in Chinese male patients with type 2 diabetes can be well predicted by anthropometric measurements.