Inflammatory markers among hiv participants with and without glucose metabolic disorder after attaining undetectable viremia in Dar Es Salaam Tanzania

Abstract

Back ground: HIV related inflammation is associated with an increased risk of getting Glucose metabolic disorders, however there is limited data linking inflammation and glucose metabolic disorder in Sub Saharan Africa. Objectives: To determine the levels of inflammatory markers among HIV positive patients with glucose metabolic disorders and those without glucose metabolic disorders. Methods: A comparative cross-sectional study was carried out at the infectious disease control clinic (IDC) in Tanzania from March to May 2018. Purposive sampling was used to obtain participants who had undetectable viral load, on 1st line ART and had taken their last meal >8hrs ago. The WHO step wise questionnaire was used to collect demographic, and social behavioral characteristics. Physical measurements were done to determine blood pressure, BMI and waist to height ratio. Blood samples were collected to test for inflammatory markers (IL6 and CRP) and blood glucose. Statistical analysis was done using Statistical Package Social Sciences (SPSS) version 23. Chi square was used to measure the association, and binary Logistic regression was used to estimate the odds ratio. A p value less than 5% was statistically significant. Results: A total of 240 participants were enrolled. Of those enrolled, 42% percent were overweight/obese (>25kg/m2) and 89% had a high waist to height ratio. The median ART duration was 8 (5-10) years. The prevalence of glucose metabolic disorders among the HIV population was 33%. Those who had inflammation (CRP) and glucose metabolic disorders (46%) were two times the number of those who had inflammation without glucose metabolic (28%) (P-value – 0.019). CRP was associated with a 1.95 fold increased odds of having glucose metabolic disorders. (OR-1.95 (1.09-4.3) (p=0.019). We did not find a significant association between IL-6 and glucose metabolic disorder. Conclusion: There was a significant difference in the levels of inflammation (CRP) among those with glucose metabolic disorders compared to those without. Recommendation: Further studies are required with a bigger sample size and a control group.