Unhealthy alcohol use is prevalent among persons living with HIV (PLWH). Aging and increased survival of PLWH on antiretroviral therapy (ART) are complicated by metabolic dysregulation and increased risk of insulin resistance (IR) and diabetes mellitus. The objective of this study was to determine the prevalence and association of IR with unhealthy alcohol use in adult in-care PLWH. A cross-sectional analysis of metabolic parameters and alcohol use characteristics was conducted in adult PLWH enrolled in the New Orleans Alcohol Use in HIV (NOAH) Study. IR was estimated using homeostatic model assessment (HOMA-IR), triglyceride index, and McAuley index and beta cell function (HOMA-β). Alcohol use was assessed using Alcohol Use Disorders Identification Test (AUDIT)-C, 30-day timeline followback (TLFB), lifetime drinking history, and phosphatidylethanol (PEth) measures. A total of 351 participants, with a mean age [±standard deviation (SD)] of 48.1 ± 10.4 years, were included (69.6% male). Of these, 57% had an AUDIT-C score of 4 or greater, indicating unhealthy alcohol use. Mean body mass index (BMI) was 27.2 ± 7.0 kg/m², 36.4% met criteria for metabolic syndrome, and 14% were diagnosed with diabetes. After adjusting for education, race, BMI, smoking status, viral load, CD4 count, use of protease inhibitors, statins, or metformin; physical activity and diabetes diagnosis, HOMA-IR, and McAuley index were negatively associated with AUDIT-C, and HOMA-β cell function was negatively associated with AUDIT-C, PEth, and TLFB. Cross-sectional analysis of NOAH participants indicates that alcohol use is associated with decreased HOMA-β cell function, suggesting dysregulation of endocrine pancreatic function.

中文翻译：

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成人 HIV 感染者的胰岛素抵抗流行率：酒精使用的影响。

不健康的酒精使用在 HIV 感染者 (PLWH) 中很普遍。抗逆转录病毒疗法 (ART) 中 PLWH 的衰老和存活率增加因代谢失调和胰岛素抵抗 (IR) 和糖尿病风险增加而复杂化。本研究的目的是确定 IR 与成人护理 PLWH 中不健康饮酒的患病率和关联。对参加新奥尔良 HIV 酒精使用 (NOAH) 研究的成年 PLWH 进行了代谢参数和酒精使用特征的横断面分析。IR 使用稳态模型评估 (HOMA-IR)、甘油三酯指数、麦考利指数和 β 细胞功能 (HOMA-β) 进行估计。使用酒精使用障碍识别测试 (AUDIT)-C、30 天时间线跟踪 (TLFB)、终生饮酒史、和磷脂酰乙醇 (PEth) 措施。总共包括 351 名参与者，平均年龄 [±标准差 (SD)] 为 48.1 ± 10.4 岁（69.6% 为男性）。其中，57% 的 AUDIT-C 得分为 4 或更高，表明饮酒不健康。平均体重指数 (BMI) 为 27.2 ± 7.0 kg/m² 36.4% 的人符合代谢综合征的标准，14% 的人被诊断为糖尿病。在调整教育、种族、BMI、吸烟状况、病毒载量、CD4 计数、蛋白酶抑制剂、他汀类药物或二甲双胍的使用后；体力活动和糖尿病诊断、HOMA-IR 和 McAuley 指数与 AUDIT-C 呈负相关，HOMA-β 细胞功能与 AUDIT-C、PEth 和 TLFB 呈负相关。NOAH 参与者的横断面分析表明，饮酒与 HOMA-β 细胞功能降低有关，表明内分泌胰腺功能失调。