Effect of Changes in Body Mass Index on the Risk of Cardiovascular Disease and Diabetes Mellitus in HIV-Positive Individuals: Results From the D:A:D Study
Year: 2020
Type: article
Abstract: BACKGROUND: Weight gain is common among people with HIV once antiretroviral treatment is commenced. We assess the effect of changes in body mass index (BMI), from different baseline BMI levels, on the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). METHODS: D:A:D participants receiving antiretroviral treatment were followed from their first BMI measurement to the first of either CVD or DM event, or earliest of January 2, 2016 or 6 months after last follow-up. Participants were stratified according to their baseline BMI, and changes from baseline BMI were calculated for each participant. Poisson regression models were used to assess the effects of changes on BMI on CVD or DM events. RESULTS: There were 2104 CVD and 1583 DM events over 365,287 and 354,898 person-years [rate: CVD 5.8/1000 (95% confidence interval: 5.5 to 6.0); DM 4.5/1000 (95% confidence interval: 4.2 to 4.7)]. Participants were largely men (74%), baseline mean age of 40 years, and median BMI of 23.0 (IQR: 21.0-25.3). A risk of CVD by change in BMI from baseline, stratified by baseline BMI strata showed little evidence of an increased risk of CVD with an increased BMI in any baseline BMI strata. An increase in BMI was associated with an increased risk of DM across all baseline BMI strata. CONCLUSIONS: Although increases in BMI across all levels of baseline BMI were not associated with an increased risk of CVD, such changes were consistently associated with an increased risk of DM. There was also some evidence of an increased risk of CVD with a decrease in BMI.
Authors: Kathy Petoumenos, Locadiah Kuwanda, Lene Ryom, Amanda Mocroft, Peter Reiss, Stephane De Wit, Christian Pradier, Fabrice Bonnet, Andrew Phillips, Camilla I. Hatleberg, Antonella d'Arminio Monforte, Rainer Weber, Caroline A. Sabin, Jens Lundgren, Matthew G. Law, for the D:A:D Study Group
Institutions: UNSW Sydney, Kirby Institute, University of Copenhagen, Rigshospitalet, Centre of Excellence for Health, Immunity and Infections, University College London, Amsterdam UMC Location University of Amsterdam, Stichting HIV Monitoring, Amsterdam University Medical Centers, University of Amsterdam, Université Libre de Bruxelles, Centre Hospitalier Universitaire de Saint-Pierre, Centre Hospitalier Universitaire de Nice, Université de Bordeaux, Inserm, Centre Hospitalier Universitaire de Bordeaux, Bordeaux Population Health, Hôpital Saint-André, Ospedale San Paolo, University of Zurich, University Hospital Zurich
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: National Science Foundation, amfAR, The Foundation for AIDS Research, Bristol-Myers Squibb, Pfizer, GlaxoSmithKline, Styrelsen för Internationellt Utvecklingssamarbete, Gilead Sciences, ViiV Healthcare, Australian Government, European Commission, National Research Foundation, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Danmarks Grundforskningsfond, University of New South Wales, Ministerie van Volksgezondheid, Welzijn en Sport, Agence Nationale de Recherches sur le Sida et les Hépatites Virales, Fundación Para La Innovación Y La Prospectiva En Salud En España, National Institutes of Health, U.S. Food and Drug Administration, National Institute of Allergy and Infectious Diseases, Janssen Pharmaceuticals, Cilag
Awards: G107059668, Swiss HIV Cohort Study, G2076268291, G2187258299, European Network of HIV/AIDS Cohort Studies to Coordinate at European and International Level Clinical Research on HIV/AIDS, G240136927, G2481942132, G2947194344, COMMUNITY PROGRAMS FOR CLINICAL RESEARCH ON AIDS, Center for Personalized Medicine of Infectious Complications in Immune Deficiency (PERSIMUNE), TERRY BEIRN COMMUNITY PROGRAMS FOR CLINICAL RESEARCH ON, G5189236567, Swiss HIV Cohort Study (SHCS), G9000103628, G90719556
OpenAlex ID: W3117977375