Diagnosis and Risk Factors of Prediabetes and Diabetes in People Living With Human Immunodeficiency Virus: Evaluation of Clinical and Microbiome Parameters

Omer Bar Ziv, Avivit Cahn, Tallulah Jansen, Valery Istomin, Eynat Kedem, Karen Olshtain-Pops, Sarah Israel, Yonatan Oster, Efrat Orenbuch-Harroch, Maya Korem, Jacob Strahilevitz, Itzchak Levy, Rafael Valdés-Mas, Valeria Ivanova, Eran Elinav, Eduardo Shahar, Hila Elinav*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Diabetes mellitus (DM) is more common among people living with human immunodeficiency virus (PLWH) compared with healthy individuals. In a prospective multicenter study (N = 248), we identified normoglycemic (48.7%), prediabetic (44.4%), and diabetic (6.9%) PLWH. Glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) sensitivity in defining dysglycemia was 96.8%, while addition of oral glucose tolerance test led to reclassification of only 4 patients. Inclusion of 93 additional PLWH with known DM enabled identification of multiple independent predictors of dysglycemia or diabetes: older age, higher body mass index, Ethiopian origin, HIV duration, lower integrase inhibitor exposure, and advanced disease at diagnosis. Shotgun metagenomic microbiome analysis revealed 4 species that were significantly expanded with hyperglycemia/ hyperinsulinemia, and 2 species that were differentially more prevalent in prediabetic/diabetic PLWH. Collectively, we uncover multiple potential host and microbiome predictors of altered glycemic status in PLWH, while demonstrating that FBG and HbA1c likely suffice for diabetes screening. These potential diabetic predictors merit future prospective validation.

Original languageEnglish
Pages (from-to)411-420
Number of pages10
JournalJournal of Infectious Diseases
Volume230
Issue number2
DOIs
StatePublished - 15 Aug 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Keywords

  • HIV/AIDS
  • microbiome
  • prediabetes
  • prediction and prevention
  • type 2 diabetes

Fingerprint

Dive into the research topics of 'Diagnosis and Risk Factors of Prediabetes and Diabetes in People Living With Human Immunodeficiency Virus: Evaluation of Clinical and Microbiome Parameters'. Together they form a unique fingerprint.

Cite this