Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women

dc.contributor.authorAbrahams, Zulfa
dc.contributor.authorDave, Joel A
dc.contributor.authorMaartens, Gary
dc.contributor.authorLevitt, Naomi S
dc.date.accessioned2015-08-12T06:34:52Z
dc.date.available2015-08-12T06:34:52Z
dc.date.issued2015-08-05
dc.date.updated2015-08-05T18:02:30Z
dc.description.abstractAbstract Background A number of metabolic abnormalities, such as dysglycaemia, insulin resistance, lipodystrophy and dyslipidaemia, are associated with the use of antiretroviral drugs. We aimed to assess the effects of long-term antiretroviral exposure on blood pressure, glycaemia, insulin secretion and anthropometric measures in black South African women. Methods A convenience sample of HIV-infected women on first-line ART for a median of 16 months at baseline, had the following evaluations twice, at baseline and after approximately 5 years: anthropometry, including skin fold thicknesses, blood pressure, oral glucose test, and insulin. Insulin sensitivity and secretion (HOMA-IR, IGI and DIo) were estimated. Results At baseline more than half the 103 women were using stavudine and efavirenz. The median interval between baseline and follow-up evaluation was 66 months. Weight, waist circumference, and waist-hip ratio increased over time, while limb skinfold thickness decreased over time. Systolic and diastolic blood pressure increased significantly and the proportion of participants with hypertension increased from 3.9 to 15.5% (p < 0.001). There were increases from baseline in plasma glucose concentrations at 30 and 120 min; insulin concentrations at 0 and 30 min; and IGI and DIo. The proportion of participants with diabetes increased from 1 to 7.5% (p = 0.070). Conclusion In black South African women with long-term exposure to ART, increases in hypertension and possibly diabetes were observed. Participants experienced an increase in central fat and a decrease in peripheral fat distribution. Early identification and management of these metabolic changes are important, especially in a region with the highest HIV-infected population in the world.
dc.identifier.apacitationAbrahams, Z., Dave, J. A., Maartens, G., & Levitt, N. S. (2015). Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women. <i>AIDS Research and Therapy</i>, http://hdl.handle.net/11427/13721en_ZA
dc.identifier.chicagocitationAbrahams, Zulfa, Joel A Dave, Gary Maartens, and Naomi S Levitt "Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women." <i>AIDS Research and Therapy</i> (2015) http://hdl.handle.net/11427/13721en_ZA
dc.identifier.citationAbrahams, Z., Dave, J. A., Maartens, G., & Levitt, N. S. (2015). Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women. AIDS research and therapy, 12(1), 24.
dc.identifier.ris TY - Journal Article AU - Abrahams, Zulfa AU - Dave, Joel A AU - Maartens, Gary AU - Levitt, Naomi S AB - Abstract Background A number of metabolic abnormalities, such as dysglycaemia, insulin resistance, lipodystrophy and dyslipidaemia, are associated with the use of antiretroviral drugs. We aimed to assess the effects of long-term antiretroviral exposure on blood pressure, glycaemia, insulin secretion and anthropometric measures in black South African women. Methods A convenience sample of HIV-infected women on first-line ART for a median of 16 months at baseline, had the following evaluations twice, at baseline and after approximately 5 years: anthropometry, including skin fold thicknesses, blood pressure, oral glucose test, and insulin. Insulin sensitivity and secretion (HOMA-IR, IGI and DIo) were estimated. Results At baseline more than half the 103 women were using stavudine and efavirenz. The median interval between baseline and follow-up evaluation was 66 months. Weight, waist circumference, and waist-hip ratio increased over time, while limb skinfold thickness decreased over time. Systolic and diastolic blood pressure increased significantly and the proportion of participants with hypertension increased from 3.9 to 15.5% (p < 0.001). There were increases from baseline in plasma glucose concentrations at 30 and 120 min; insulin concentrations at 0 and 30 min; and IGI and DIo. The proportion of participants with diabetes increased from 1 to 7.5% (p = 0.070). Conclusion In black South African women with long-term exposure to ART, increases in hypertension and possibly diabetes were observed. Participants experienced an increase in central fat and a decrease in peripheral fat distribution. Early identification and management of these metabolic changes are important, especially in a region with the highest HIV-infected population in the world. DA - 2015-08-05 DB - OpenUCT DO - 10.1186/s12981-015-0065-8 DP - University of Cape Town J1 - AIDS Research and Therapy LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women TI - Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women UR - http://hdl.handle.net/11427/13721 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/13721
dc.identifier.urihttp://dx.doi.org/10.1186/s12981-015-0065-8
dc.identifier.vancouvercitationAbrahams Z, Dave JA, Maartens G, Levitt NS. Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women. AIDS Research and Therapy. 2015; http://hdl.handle.net/11427/13721.en_ZA
dc.language.rfc3066en
dc.publisher.departmentDivision of Endocrinology and Diabetologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License*
dc.rights.holderAbrahams et al.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0*
dc.sourceAIDS Research and Therapyen_ZA
dc.source.urihttp://www.aidsrestherapy.com
dc.subject.otherHIVen_ZA
dc.subject.otherDysglycaemiaen_ZA
dc.subject.otherHypertensionen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherBody compositionen_ZA
dc.subject.otherLipoatrophyen_ZA
dc.subject.otherBlood pressureen_ZA
dc.titleChanges in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women
dc.typeJournal Articleen_ZA
uct.type.filetype
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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