Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART

Nicola Squillace, Patrizia Lorenzini, Giuseppe Lapadula, Alessandra Bandera, Alessandro Cozzi-Lepri, Stefano Rusconi, Massimo Puoti, Antonella Castagna, Andrea Antinori, Andrea Gori, Antonella d'Arminio Monforte, Icona Foundation Study Group

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Our primary aim was to study diabetes mellitus (DM) arising during combination ART (cART) and to attempt to identify associations between these cases and triglycerides (TRG) and the TRG to HDL-cholesterol (TRG/HDL) ratio. Our secondary aim was to analyse the association between DM development and hepatic fibrosis.

METHODS: This was a retrospective cohort study. Patients from the Icona Foundation study initiating first-line cART between 1997 and 2013 were selected and observed until new-onset DM or most recent clinical follow-up. The predictive value of TRG and TRG/HDL ratio levels on DM was evaluated using multivariable Poisson regression models.

RESULTS: Three-thousand, five-hundred and forty-six patients (males, 73.7%; median age, 38 years; median BMI, 23.1 kg/m(2); and hepatitis C virus antibody positive, 22.1%) were included. Of these, 80 developed DM over 13 911 person-years of follow-up (PYFU), corresponding to 5.7 cases per 1000 PYFU (95% CI = 4.6-7.1). At multivariable analysis, latest TRG/HDL ratio, when high, was associated with significant increases in DM risk [relative risk (RR) = 1.63; 95% CI = 1.32-2.01 per 10 points higher], while current TRG, in contrast, was associated with new-onset DM only at crude analysis. Advanced liver fibrosis (defined as fibrosis-4 index >3.25) was also shown to be an independent risk factor for DM (RR = 2.91; 95% CI = 1.10-7.72).

CONCLUSIONS: High TRG/HDL ratio predicted risk of new-onset DM, independently of other traditional risk factors. Furthermore, our findings suggest that advanced hepatic fibrosis, estimated using the fibrosis-4 score, could provide an additional predictor for DM.

Original languageEnglish
Pages (from-to)2663-9
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Volume71
Issue number9
DOIs
Publication statusPublished - Sep 2016

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Diabetes Mellitus
Triglycerides
Fibrosis
Hepatitis C Antibodies
Liver
Liver Cirrhosis
HDL Cholesterol
Cohort Studies
Retrospective Studies
Odds Ratio

Keywords

  • Journal Article

Cite this

Squillace, N., Lorenzini, P., Lapadula, G., Bandera, A., Cozzi-Lepri, A., Rusconi, S., ... Icona Foundation Study Group (2016). Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART. Journal of Antimicrobial Chemotherapy, 71(9), 2663-9. https://doi.org/10.1093/jac/dkw185

Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART. / Squillace, Nicola; Lorenzini, Patrizia; Lapadula, Giuseppe; Bandera, Alessandra; Cozzi-Lepri, Alessandro; Rusconi, Stefano; Puoti, Massimo; Castagna, Antonella; Antinori, Andrea; Gori, Andrea; d'Arminio Monforte, Antonella; Icona Foundation Study Group.

In: Journal of Antimicrobial Chemotherapy, Vol. 71, No. 9, 09.2016, p. 2663-9.

Research output: Contribution to journalArticle

Squillace, N, Lorenzini, P, Lapadula, G, Bandera, A, Cozzi-Lepri, A, Rusconi, S, Puoti, M, Castagna, A, Antinori, A, Gori, A, d'Arminio Monforte, A & Icona Foundation Study Group 2016, 'Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART', Journal of Antimicrobial Chemotherapy, vol. 71, no. 9, pp. 2663-9. https://doi.org/10.1093/jac/dkw185
Squillace, Nicola ; Lorenzini, Patrizia ; Lapadula, Giuseppe ; Bandera, Alessandra ; Cozzi-Lepri, Alessandro ; Rusconi, Stefano ; Puoti, Massimo ; Castagna, Antonella ; Antinori, Andrea ; Gori, Andrea ; d'Arminio Monforte, Antonella ; Icona Foundation Study Group. / Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART. In: Journal of Antimicrobial Chemotherapy. 2016 ; Vol. 71, No. 9. pp. 2663-9.
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abstract = "OBJECTIVES: Our primary aim was to study diabetes mellitus (DM) arising during combination ART (cART) and to attempt to identify associations between these cases and triglycerides (TRG) and the TRG to HDL-cholesterol (TRG/HDL) ratio. Our secondary aim was to analyse the association between DM development and hepatic fibrosis.METHODS: This was a retrospective cohort study. Patients from the Icona Foundation study initiating first-line cART between 1997 and 2013 were selected and observed until new-onset DM or most recent clinical follow-up. The predictive value of TRG and TRG/HDL ratio levels on DM was evaluated using multivariable Poisson regression models.RESULTS: Three-thousand, five-hundred and forty-six patients (males, 73.7{\%}; median age, 38 years; median BMI, 23.1 kg/m(2); and hepatitis C virus antibody positive, 22.1{\%}) were included. Of these, 80 developed DM over 13 911 person-years of follow-up (PYFU), corresponding to 5.7 cases per 1000 PYFU (95{\%} CI = 4.6-7.1). At multivariable analysis, latest TRG/HDL ratio, when high, was associated with significant increases in DM risk [relative risk (RR) = 1.63; 95{\%} CI = 1.32-2.01 per 10 points higher], while current TRG, in contrast, was associated with new-onset DM only at crude analysis. Advanced liver fibrosis (defined as fibrosis-4 index >3.25) was also shown to be an independent risk factor for DM (RR = 2.91; 95{\%} CI = 1.10-7.72).CONCLUSIONS: High TRG/HDL ratio predicted risk of new-onset DM, independently of other traditional risk factors. Furthermore, our findings suggest that advanced hepatic fibrosis, estimated using the fibrosis-4 score, could provide an additional predictor for DM.",
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T1 - Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART

AU - Squillace, Nicola

AU - Lorenzini, Patrizia

AU - Lapadula, Giuseppe

AU - Bandera, Alessandra

AU - Cozzi-Lepri, Alessandro

AU - Rusconi, Stefano

AU - Puoti, Massimo

AU - Castagna, Antonella

AU - Antinori, Andrea

AU - Gori, Andrea

AU - d'Arminio Monforte, Antonella

AU - Icona Foundation Study Group

N1 - © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

PY - 2016/9

Y1 - 2016/9

N2 - OBJECTIVES: Our primary aim was to study diabetes mellitus (DM) arising during combination ART (cART) and to attempt to identify associations between these cases and triglycerides (TRG) and the TRG to HDL-cholesterol (TRG/HDL) ratio. Our secondary aim was to analyse the association between DM development and hepatic fibrosis.METHODS: This was a retrospective cohort study. Patients from the Icona Foundation study initiating first-line cART between 1997 and 2013 were selected and observed until new-onset DM or most recent clinical follow-up. The predictive value of TRG and TRG/HDL ratio levels on DM was evaluated using multivariable Poisson regression models.RESULTS: Three-thousand, five-hundred and forty-six patients (males, 73.7%; median age, 38 years; median BMI, 23.1 kg/m(2); and hepatitis C virus antibody positive, 22.1%) were included. Of these, 80 developed DM over 13 911 person-years of follow-up (PYFU), corresponding to 5.7 cases per 1000 PYFU (95% CI = 4.6-7.1). At multivariable analysis, latest TRG/HDL ratio, when high, was associated with significant increases in DM risk [relative risk (RR) = 1.63; 95% CI = 1.32-2.01 per 10 points higher], while current TRG, in contrast, was associated with new-onset DM only at crude analysis. Advanced liver fibrosis (defined as fibrosis-4 index >3.25) was also shown to be an independent risk factor for DM (RR = 2.91; 95% CI = 1.10-7.72).CONCLUSIONS: High TRG/HDL ratio predicted risk of new-onset DM, independently of other traditional risk factors. Furthermore, our findings suggest that advanced hepatic fibrosis, estimated using the fibrosis-4 score, could provide an additional predictor for DM.

AB - OBJECTIVES: Our primary aim was to study diabetes mellitus (DM) arising during combination ART (cART) and to attempt to identify associations between these cases and triglycerides (TRG) and the TRG to HDL-cholesterol (TRG/HDL) ratio. Our secondary aim was to analyse the association between DM development and hepatic fibrosis.METHODS: This was a retrospective cohort study. Patients from the Icona Foundation study initiating first-line cART between 1997 and 2013 were selected and observed until new-onset DM or most recent clinical follow-up. The predictive value of TRG and TRG/HDL ratio levels on DM was evaluated using multivariable Poisson regression models.RESULTS: Three-thousand, five-hundred and forty-six patients (males, 73.7%; median age, 38 years; median BMI, 23.1 kg/m(2); and hepatitis C virus antibody positive, 22.1%) were included. Of these, 80 developed DM over 13 911 person-years of follow-up (PYFU), corresponding to 5.7 cases per 1000 PYFU (95% CI = 4.6-7.1). At multivariable analysis, latest TRG/HDL ratio, when high, was associated with significant increases in DM risk [relative risk (RR) = 1.63; 95% CI = 1.32-2.01 per 10 points higher], while current TRG, in contrast, was associated with new-onset DM only at crude analysis. Advanced liver fibrosis (defined as fibrosis-4 index >3.25) was also shown to be an independent risk factor for DM (RR = 2.91; 95% CI = 1.10-7.72).CONCLUSIONS: High TRG/HDL ratio predicted risk of new-onset DM, independently of other traditional risk factors. Furthermore, our findings suggest that advanced hepatic fibrosis, estimated using the fibrosis-4 score, could provide an additional predictor for DM.

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JO - Journal of Antimicrobial Chemotherapy

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