Relationship between estimated cardiovascular disease risk and insulin resistance in a black African population living with HIV: a cross-sectional study from Cameroon

BMJ Open. 2017 Aug 11;7(8):e016835. doi: 10.1136/bmjopen-2017-016835.

Abstract

Objectives: Cardiovascular disease (CVD) and metabolic diseases are growing concerns among patients with HIV infection as a consequence of the improving survival of this population. We aimed to assess the relationship between CVD risk and insulin resistance in a group of black African individuals with HIV infection.

Methods: This cross-sectional study involved patients with HIV infection aged 30-74 years and followed up at the Yaoundé Central Hospital, Cameroon. Absolute CVD risk was calculated using the Framingham and the DAD CVD risk equations while the HOMA-IR index was used to assess insulin resistance (index ≥2.1).

Results: A total of 452 patients (361 women; 80%) were screened. The mean age was 44.4 years and most of the respondents were on antiretroviral therapy (88.5%). The median 5-year cardiovascular risk was 0.7% (25th-75th percentiles: 0.2-2.0) and 0.6% (0.3-1.3) according to the Framingham and DAD equations respectively. Of all participants, 47.3% were insulin resistant. The Framingham equation derived absolute CVD risk was significantly associated with insulin resistance; while no linear association was found using the DAD equation.

Conclusion: The relationship between cardiovascular risk and insulin resistance in black African patients with HIV infection seems to depend on the cardiovascular risk equation used.

Keywords: Cameroon; HIV; cardiovascular risk; insulin resistance.

MeSH terms

  • Adult
  • Aged
  • Black People*
  • Cameroon
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / complications*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / complications*
  • Humans
  • Insulin / blood*
  • Insulin Resistance*
  • Male
  • Middle Aged
  • Models, Biological
  • Risk Assessment
  • Risk Factors

Substances

  • Insulin