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Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART.

Squillace, N; Lorenzini, P; Lapadula, G; Bandera, A; Cozzi-Lepri, A; Rusconi, S; Puoti, M; ... Icona Foundation Study Group, ; + view all (2016) Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART. J Antimicrob Chemother , 71 (9) pp. 2663-2669. 10.1093/jac/dkw185. Green open access

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Abstract

OBJECTIVES: Our primary aim was to study diabetes mellitus (DM) arising during combination ART (cART) and to attempt to identify associations between these cases and triglycerides (TRG) and the TRG to HDL-cholesterol (TRG/HDL) ratio. Our secondary aim was to analyse the association between DM development and hepatic fibrosis. METHODS: This was a retrospective cohort study. Patients from the Icona Foundation study initiating first-line cART between 1997 and 2013 were selected and observed until new-onset DM or most recent clinical follow-up. The predictive value of TRG and TRG/HDL ratio levels on DM was evaluated using multivariable Poisson regression models. RESULTS: Three-thousand, five-hundred and forty-six patients (males, 73.7%; median age, 38 years; median BMI, 23.1 kg/m(2); and hepatitis C virus antibody positive, 22.1%) were included. Of these, 80 developed DM over 13 911 person-years of follow-up (PYFU), corresponding to 5.7 cases per 1000 PYFU (95% CI = 4.6-7.1). At multivariable analysis, latest TRG/HDL ratio, when high, was associated with significant increases in DM risk [relative risk (RR) = 1.63; 95% CI = 1.32-2.01 per 10 points higher], while current TRG, in contrast, was associated with new-onset DM only at crude analysis. Advanced liver fibrosis (defined as fibrosis-4 index >3.25) was also shown to be an independent risk factor for DM (RR = 2.91; 95% CI = 1.10-7.72). CONCLUSIONS: High TRG/HDL ratio predicted risk of new-onset DM, independently of other traditional risk factors. Furthermore, our findings suggest that advanced hepatic fibrosis, estimated using the fibrosis-4 score, could provide an additional predictor for DM.

Type: Article
Title: Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/jac/dkw185
Publisher version: https://doi.org/10.1093/jac/dkw185
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: High density lipoprotein cholesterol, triglycerides, body mass index procedure, diabetes mellitus, diabetes mellitus, type 2, high density lipoproteins, hepatic fibrosis, symptom onset
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1508729
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