未接受抗病毒治疗的男性HIV/AIDS病人胰岛β细胞功能分析  

Analysis on pancreatic islet β-cell function and influencing factors of male HIV positives before receiving antiviral therapy

作　　者：兰丽娟 刘大凤 何盛华 刘亚玲 周锐峰 蔡琳 王永 欣怡 包蕾 胡芯华 

机构地区：[1]成都市公共卫生临床医疗中心,成都610061

出　　处：《中国艾滋病性病》2016年第2期73-76,共4页Chinese Journal of Aids & STD

基　　金："十二五"国家科技重大专项课题(2012ZX10001-003);四川省卫生厅课题(130430)~~

摘　　要：目的探讨正常体重、正常糖耐量的男性艾滋病病毒(HIV)感染初治患者,其胰岛β细胞的功能和影响因素。方法采用前瞻性病例对照研究。分析50例正常体重、正常糖耐量的男性初治HIV感染者/艾滋病(AIDS)病人(病例组),与50例同期同年龄正常体重、正常糖耐量的男性非HIV感染者/AIDS病人(对照组),其胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能(HOMA-β)的差异。运用Pearson相关分析、偏相关分析及多元逐步回归分析方法,找寻影响正常体重正常糖耐量男性HIV初治患者HOMA-β的主要因素。结果 1)在年龄相近的情况下,病例组HOMA-IR、HOMA-β均低于对照组,组间比较有统计学意义(t值分别为2.967、5.011,P值分别为0.004、0.000);2)无论是病例组还是对照组,HOMA-IR、HOMA-β均与年龄呈负相关(r值分别为-0.509、-0.324、0.509、-0.358,P值分别为0.003、0.024、0.001、0.011);3)病例组HOMA-IR与病毒载量呈负相关(r=-0.474,P=0.003),HOMA-β与病毒载量有一定的负相关关系(r=0.368,P=0.077),两者均与CD4^+T淋巴细胞计数无相关关系;4)控制年龄后偏相关分析显示,病例组HOMA-IR仍与病毒载量呈负相关(r=-0.597,P=0.024),HOMA-β仍与病毒载量有一定的负相关关系(r=-0.668,P=0.091);5)多元逐步回归分析显示,病毒载量是病例组HOMA-IR的独立影响因素,而年龄则是HOMA-β的独立影响因素。结论即使是青年、体重正常、糖耐量正常、胰岛素抵抗并不明显的初治男性HIV感染者/AIDS病人,胰岛β细胞功能减退均较普遍;HIV病毒载量高低均会对该类人群胰岛素抵抗及胰岛β细胞功能产生负性影响。Objective To investigate pancreatic islet β-cell function and the influencing factors of male HIV positives with normal weight and glucose tolerance.Methods The prospective case control study was conducted to analyze the difference of pancreatic islet β-cell function between 50 of male HIV positives（case group） and 50 of male HIV negatives at the same age（control group） in the normal weight and glucose tolerance.Pearson correlation analysis,partial correlation analysis and multiple regression analysis were used to know the influencing factors on pancreatic islet beta cell function.Results 1） The homeostasis model assessment of insulin resistance（HOMA-IR） and homeostasis model assessment of β cells（HOMA-β） in the case group were significantly lower than that in the control group（t scores 2.967,5.011,and P scores 0.004,0.000 respectively）;2） Both groups showed HOMA-IR and HOMA-β were negatively correlated with age（r scores-0.509,-0.324,-0.509,-0.358,P scores 0.003,0.024,0.001,0.011）;3） HOMA-IR（r scores-0.474,P scores 0.003） and HOMA-β（r scores-0.368,P scores 0.077） of the case group were negatively correlated with viral load,and had no correlation with CD4~＋ T lymphocyte count.4） After control of age,partial correlation analysis showed that HOMA-IR（r scores-0.597,P scores 0.024） and HOMA-β（r scores-0.668,P scores 0.091） were still negatively correlated with viral load;5） Multiple regression analysis showed that viral load and age were the independent factors on HOMA-IR,and HOMA-β in the case group.Conclusion Even if the male HIV positives are young,with normal weight and glucose tolerance,their pancreatic islet β-cell function impairment is common.HIV virus itself and the viral load negatively affect insulin resistance and pancreatic islet β-cell function of the case group.

关 键 词：艾滋病 抗病毒治疗 男性初治患者 胰岛Β细胞功能 

分 类 号：R512.91[医药卫生—内科学]