Integrase Strand Transfer Inhibitor-Related Changes in Body Mass Index and Risk of Diabetes: A Prospective Study From...

Area of Science:

• Infectious Diseases
• Endocrinology
• Public Health

Background:

• Integrase strand transfer inhibitors (INSTIs) are associated with increased body mass index (BMI).
• Increased BMI is a known risk factor for developing diabetes mellitus (DM).
• The relationship between INSTI use, BMI changes, and DM risk requires further investigation.

Purpose of the Study:

• To explore the associations between INSTI/non-INSTI regimens, BMI changes, and the risk of developing DM in people with HIV.
• To quantify the impact of INSTI use on DM risk, considering BMI as a potential mediator.

Main Methods:

• Utilized data from the RESPOND cohort, including participants with HIV and at least two BMI measurements.
• Defined DM using standard criteria: blood glucose, HbA1c, antidiabetic medication, or clinical diagnosis.
• Employed Poisson regression to analyze the association between time-updated BMI, INSTI/non-INSTI use, and DM risk.

Main Results:

• The study included 20,865 people with HIV; 785 developed DM.
• Higher BMI was strongly associated with increased DM risk (aIRR, 16.54 per log increase).
• Current INSTI use was associated with increased DM risk (aIRR, 1.48), even after adjusting for BMI and other factors.

Conclusions:

• INSTI use is independently associated with an increased risk of developing DM in people with HIV.
• This association persists even when accounting for body mass index changes.
• Findings suggest careful monitoring for DM in individuals on INSTI-based antiretroviral therapy.