10th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 6-8 November 2008, London, UK

LOW PHYSICAL FUNCTION IS ASSOCIATED WITH DIABETES MELLITUS AMONG HIV-INFECTED AND HIV-NEGATIVE MEN

Antiviral Therapy 2008; 13(Suppl. 4):A31 (abstract no. P-12)

A Longenberger¹, J Lim², TJ Orchard¹, M Brooks¹, J Brach³, K Mertz¹ and LA Kingsley^1,4
1University of Pittsburgh, Department of Epidemiology, Pittsburgh, PA, USA; ²University of Pittsburgh, Department of Biostatistics, Pittsburgh, PA, USA; ³University of Pittsburgh, Health and Rehabilitation Sciences, Pittsburgh, PA, USA; ⁴University of Pittsburgh, Department of Infectious Diseases and Microbiology, Pittsburgh, PA, USA

OBJECTIVES: Low physical activity is a contributing factor to both diabetes mellitus (DM) and insulin resistance (IR) has been overlooked in most studies of HIV-infected populations despite a known association in the general population. The objective of this study was to investigate low physical function (a surrogate for physical activity) as a contributor to DM and IR among HIV-infected and HIV-negative men.

METHODS: In total, 384 HIV-negative and 274 HIV-infected men (n=658) from the Pittsburgh centre of the Multicenter AIDS Cohort Study contributed clinical and physical function data. DM was defined by a fasting serum glucose >126 mg/dl. IR was calculated using the homeostasis model assessment (HOMA). The Physical Functioning Ten Scale from the Short Form-36 Health Survey assessed baseline physical function with a lower score indicating lower physical function. Baseline covariates included age, race, HIV, AIDS, body mass index (BMI) and CD4+ T-cell count. Multivariate logistic regression analysis was used to assess the independent association between physical function and DM as well as physical function and IR.

RESULTS: HIV-negative men with normoglycaemia had the highest physical function scores. HIV-negative men had better physical function scores than HIV-infected men regardless of glucose level. In both HIV-negative and HIV-infected men, lower physical function scores were observed among individuals with DM compared with those with normoglycaemia. Men with both diabetes and AIDS had the lowest mean physical function score among all groups. In both HIV-negative and HIV-infected men, physical function scores were lower in men with hyperinsulinaemia and in men with higher HOMA scores. In multivariate analysis, lower physical function score (odds ratio [OR]=1.5 per 25 unit decrease, P=0.02), older age (OR=1.5 per 5 years, P<0.0001) and Black race (OR=2.8, P=0.002) were associated with DM. In addition, older age (OR=1.3 per 5 years, P<0.0001), higher BMI (OR=2.8 per 5 units, P<0.0001), HIV infection (OR=11.3, P=0.01), black race (OR=2.0, P=0.004) and the interaction between HIV and physical function (OR=2.1, P=0.0003) were associated with IR.

CONCLUSIONS: This study suggests that low physical function (as a surrogate for physical activity) is associated with DM and IR in both HIV-infected and HIV-negative men. Future research using objective physical activity measures is warranted to further understand the contribution of low physical activity to DM and IR among HIV-infected populations. Ongoing HIV cohort studies should address the role of physical activity as an important contributor to impaired glucose metabolism.

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2008-11-06
P-12

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