Search

Background: The role of body fat on metabolic complications remains poorly understood in young people living with perinatally acquired HIV (YPHIV). Objective: Our objective was to assess the association of changes in adiposity over 2 years with metabolic outcomes in YPHIV. Methods: The PHACS Adolescent Master Protocol (AMP) study enrolled YPHIV from 2007 to 2009 across 15 US sites, including Puerto Rico. We included YPHIV aged 7–19 years with body composition data assessed by whole‐body dual‐energy X‐ray absorptiometry (DXA) at baseline and 2 years later. Metabolic outcomes included homeostatic model assessment of insulin resistance (HOMA‐IR) and non‐high‐density lipoprotein cholesterol (non‐HDL‐C). We fitted linear regression models to assess the association of increase in body fat over 2 years with metabolic outcomes at years 2 and 3. Results: In all, 232 participants had a second DXA and either HOMA‐IR or non‐HDL‐C measured at year 2. Participant characteristics at the first DXA were: age 12 years (9–14) [median (Q1–Q3)], 69% Black, and median CD4 count 714 cells/μL; 70% with HIV RNA <400 copies/mL. In adjusted analyses for every 1% increase in body fat from baseline to year 2, HOMA‐IR was higher by 1.03‐fold at year 3 (95% CI: 1.00, 1.05). We observed that for every 1% increase in body fat from baseline to year 2, non‐HDL‐C was 0.72 mg/dL higher at year 2 (95% CI: −0.04–1.49) and 0.81 mg/dL higher at year 3 (95% CI: −0.05–1.66). Conclusions: Increases in adiposity over time may lead to downstream decreased insulin sensitivity and dyslipidaemia in YPHIV. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the incidence of type 2 diabetes mellitus (T2DM) and hyperlipidemia (HLD) in CML patients initiating therapy with dasatinib or nilotinib., Methods: Retrospective study using MarketScan claims from January 2006 to December 2014. The first analysis evaluated occurrence of T2DM, defined as ≥2 claims with a T2DM ICD-9 code or 1 diagnosis claim and an antidiabetic medication. The second analysis evaluated occurrence of HLD, defined as ≥2 claims with an HLD ICD-9 code, or 1 diagnosis claim and an anti-HLD medication. Incidence rates were computed as number of events divided by sum of person years (PY) at risk for all subjects. Multivariate Cox proportional hazards models estimated hazard ratios (HRs) for T2DM or HLD., Results: There were 2004 and 1280 patients who met the criteria for the T2DM analysis (n = 1272 dasatinib, n = 732 nilotinib) and HLD analysis (n = 845 dasatinib, n = 435 nilotinib). The incidence rate of T2DM was 40.4 per 1000 PY (95% CI: 27.60, 56.98) for nilotinib and 17.6 per 1000 PY (95% CI: 11.14, 26.38) for dasatinib. HR for occurrence of T2DM was 2.77 (95% CI: 1.58, 4.86), indicating that patients on nilotinib had a significantly higher adjusted risk for incident T2DM. The incidence rate of HLD was 74.6 per 1000 PY (95% CI: 50.70, 105.94) for nilotinib and 46.4 per 1000 PY (95% CI: 33.00, 63.45) for dasatinib. HR for occurrence of HLD was 1.75 (95% CI: 1.07, 2.87) indicating that patients on nilotinib had a significantly higher adjusted risk for incident HLD., Conclusions: Patients receiving nilotinib had significantly higher rates of incident T2DM or HLD than patients on dasatinib.