Mary C Masters1, Jingyan Yang2, Jordan E Lake3, Alison G Abraham4,5, Lawrence Kingsley6,7, Todd T Brown8, Frank J Palella1, Kristine M Erlandson9. 1. Department of Medicine, Northwestern University, Chicago, Illinois. 2. Department of Epidemiology, Mailman School of Public Heath, Columbia University, New York, New York. 3. Department of Internal Medicine, McGovern Medical School, University of Texas, Houston, Texas. 4. Department of Ophthalmology, Johns Hopkins University School of Medicine. 5. Department of Epidemiology, The Johns Hopkins School of Public Health, Baltimore, Maryland. 6. Department of Infectious Diseases and Microbiology. 7. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. 8. Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland. 9. Department of Medicine, University of Colorado, Aurora, Colorado, USA.
Abstract
OBJECTIVE: To determine the longitudinal relationships between abnormal glucose metabolism and physical function in persons with HIV (PWH) and without HIV. DESIGN: Prospective cohort study of men with or at risk for HIV in four United States cities between 2006 and 2018. METHODS: Men with or at risk for HIV from the Multicenter AIDS Cohort Study (MACS) had semi-annual assessments of glycemic status, grip strength, and gait speed. We used linear mixed models with random intercept to assess associations between glycemic status and physical function. Glycemic status was categorized as normal, impaired fasting glucose (IFG), controlled diabetes mellitus [hemoglobin A1C (HbA1C) <7.5%], or uncontrolled diabetes mellitus (HbA1C ≥ 7.5%). RESULTS: Of 2240 men, 52% were PWH. Diabetes mellitus was similar among PWH (7.7%) vs. persons without HIV (6.7%, P = 0.36) at baseline. PWH had slower gait speed (1.17 vs. 1.20 m/s, P < 0.01) but similar grip strength (40.1 vs. 39.8 kg, P = 0.76) compared with persons without HIV at baseline. In multivariate models, gait speed decline was greater with controlled diabetes mellitus [-0.018 m/s (-0.032 to -0.005), P = 0.01] and grip strength decline was greater with controlled [-0.560 kg (-1.096 to -0.024), P = 0.04] and uncontrolled diabetes mellitus [-0.937 kg (-1.684 to -0.190), P = 0.01), regardless of HIV serostatus compared with normoglycemic individuals. DISCUSSION: Abnormal glucose metabolism was associated with declines in gait speed and grip strength regardless of HIV serostatus. These data suggest that improvement in glucose control should be investigated as an intervenable target to prevent progression of physical function limitations among PWH.
OBJECTIVE: To determine the longitudinal relationships between abnormal glucose metabolism and physical function in persons with HIV (PWH) and without HIV. DESIGN: Prospective cohort study of men with or at risk for HIV in four United States cities between 2006 and 2018. METHODS: Men with or at risk for HIV from the Multicenter AIDS Cohort Study (MACS) had semi-annual assessments of glycemic status, grip strength, and gait speed. We used linear mixed models with random intercept to assess associations between glycemic status and physical function. Glycemic status was categorized as normal, impaired fasting glucose (IFG), controlled diabetes mellitus [hemoglobin A1C (HbA1C) <7.5%], or uncontrolled diabetes mellitus (HbA1C ≥ 7.5%). RESULTS: Of 2240 men, 52% were PWH. Diabetes mellitus was similar among PWH (7.7%) vs. persons without HIV (6.7%, P = 0.36) at baseline. PWH had slower gait speed (1.17 vs. 1.20 m/s, P < 0.01) but similar grip strength (40.1 vs. 39.8 kg, P = 0.76) compared with persons without HIV at baseline. In multivariate models, gait speed decline was greater with controlled diabetes mellitus [-0.018 m/s (-0.032 to -0.005), P = 0.01] and grip strength decline was greater with controlled [-0.560 kg (-1.096 to -0.024), P = 0.04] and uncontrolled diabetes mellitus [-0.937 kg (-1.684 to -0.190), P = 0.01), regardless of HIV serostatus compared with normoglycemic individuals. DISCUSSION: Abnormal glucose metabolism was associated with declines in gait speed and grip strength regardless of HIV serostatus. These data suggest that improvement in glucose control should be investigated as an intervenable target to prevent progression of physical function limitations among PWH.
Authors: Kristine M Erlandson; Derek K Ng; Lisa P Jacobson; Joseph B Margolick; Adrian S Dobs; Frank J Palella; Jordan E Lake; Hanhvy Bui; Lawrence Kingsley; Todd T Brown Journal: J Infect Dis Date: 2017-01-15 Impact factor: 5.226
Authors: Kathleen V Fitch; Ellen J Anderson; Jane L Hubbard; Sara J Carpenter; William R Waddell; Angela M Caliendo; Steven K Grinspoon Journal: AIDS Date: 2006-09-11 Impact factor: 4.177