Association of HIV-1 Infection and Antiretroviral Therapy With Type 2 Diabetes in the Hispanic Population of the Rio Grande Valley, Texas, USA

Authors

Juan Carlos Lopez Alvarenga, The University of Texas Rio Grande ValleyFollow
Dora A. Martinez
Alvaro Diaz-Badillo, The University of Texas Rio Grande Valley, Universidad Mexico Americana del NorteFollow
Liza D. Morales, The University of Texas Rio Grande Valley
Rector Arya, The University of Texas Rio Grande Valley
Christopher Jenkinson, The University of Texas Rio Grande Valley
Joanne E. Curran, The University of Texas Rio Grande ValleyFollow
John Blangero, The University of Texas Rio Grande ValleyFollow
Ravi Duggirala, The University of Texas Rio Grande ValleyFollow
Srinivas Mummidi, The University of Texas Rio Grande ValleyFollow
Ruben D. Martinez

Document Type

Article

Publication Date

7-5-2021

Abstract

The Rio Grande Valley (RGV) in South Texas has one of the highest prevalence of obesity and type 2 diabetes (T2D) in the United States (US). We report for the first time the T2D prevalence in persons with HIV (PWH) in the RGV and the interrelationship between T2D, cardiometabolic risk factors, HIV-related indices, and antiretroviral therapies (ART). The PWH in this study received medical care at Valley AIDS Council (VAC) clinic sites located in Harlingen and McAllen, Texas. Henceforth, this cohort will be referred to as Valley AIDS Council Cohort (VACC). Cross-sectional analyses were conducted using retrospective data obtained from 1,827 registries. It included demographic and anthropometric variables, cardiometabolic traits, and HIV-related virological and immunological indices. For descriptive statistics, we used mean values of the quantitative variables from unbalanced visits across 20 months. Robust regression methods were used to determine the associations. For comparisons, we used cardiometabolic trait data obtained from HIV-uninfected San Antonio Mexican American Family Studies (SAMAFS; N = 2,498), and the Mexican American population in the National Health and Nutrition Examination Survey (HHANES; N = 5,989). The prevalence of T2D in VACC was 51% compared to 27% in SAMAFS and 19% in HHANES, respectively. The PWH with T2D in VACC were younger (4.7 years) and had lower BMI (BMI 2.43 units less) when compared to SAMAFS individuals. In contrast, VACC individuals had increased blood pressure and dyslipidemia. The increased T2D prevalence in VACC was independent of BMI. Within the VACC, ART was associated with viral load and CD4+ T cell counts but not with metabolic dysfunction. Notably, we found that individuals with any INSTI combination had higher T2D risk: OR 2.08 (95%CI 1.67, 2.6; p < 0.001). In summary, our results suggest that VACC individuals may develop T2D at younger ages independent of obesity. The high burden of T2D in these individuals necessitates rigorously designed longitudinal studies to draw potential causal inferences and develop better treatment regimens.

Comments

© 2021 Lopez-Alvarenga, Martinez, Diaz-Badillo, Morales, Arya, Jenkinson, Curran, Lehman, Blangero, Duggirala, Mummidi and Martinez.

Recommended Citation

Lopez-Alvarenga, J. C., Martinez, D. A., Diaz-Badillo, A., Morales, L. D., Arya, R., Jenkinson, C. P., Curran, J. E., Lehman, D. M., Blangero, J., Duggirala, R., Mummidi, S., & Martinez, R. D. (2021). Association of HIV-1 Infection and Antiretroviral Therapy With Type 2 Diabetes in the Hispanic Population of the Rio Grande Valley, Texas, USA. Frontiers in medicine, 8, 676979. https://doi.org/10.3389/fmed.2021.676979

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication Title

Frontiers in Medicine

DOI

10.3389/fmed.2021.676979

Academic Level

faculty

Mentor/PI Department

Office of Human Genetics