Effects of nutritional supplementation on glucose metabolism and insulin function among people with HIV initiating ART
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Effects of nutritional supplementation on glucose metabolism and insulin function among people with HIV initiating ART. / Amare, Hiwot; Olsen, Mette Frahm; Friis, Henrik; Kæstel, Pernille; Andersen, Åse Bengård; Abdissa, Alemseged; Yilma, Daniel; Girma, Tsinuel; Faurholt-Jepsen, Daniel.
In: BMC Nutrition, Vol. 7, 60, 2021.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effects of nutritional supplementation on glucose metabolism and insulin function among people with HIV initiating ART
AU - Amare, Hiwot
AU - Olsen, Mette Frahm
AU - Friis, Henrik
AU - Kæstel, Pernille
AU - Andersen, Åse Bengård
AU - Abdissa, Alemseged
AU - Yilma, Daniel
AU - Girma, Tsinuel
AU - Faurholt-Jepsen, Daniel
N1 - © 2021. The Author(s).
PY - 2021
Y1 - 2021
N2 - Background: Without high-quality nutritional support, there is a risk that people infected with human immunodeficiency virus (HIV) will replace lost muscle mass with fat mass when initiating antiretroviral therapy (ART). We have shown that lipid-based nutrient supplements (LNS) with whey or soy considerably increases lean mass among Ethiopian people with HIV starting ART. Here, we aim to assess the effects of LNS on insulin function and glucose metabolism.Methods: This is a secondary analysis of a randomized trial testing the effect of three-month supplementation with LNS containing whey (LNS/whey) or soy (LNS/soy) among people with HIV. LNS/whey and LNS/soy groups were combined and then were compared against the non-supplemented group. The outcomes were change in fasting plasma-glucose (FPG), and 30-min glucose and 120-min glucose after oral glucose tolerance test. We further assessed effect on glycated hemoglobin (HbA1c), fasting insulin, homeostatic model assessment index for beta-cell function (HOMA-B) and insulin resistance (HOMA-IR).Results: Of the 318 patients enrolled, 268 (84.3%) had available FPG and HbA1c and included. After 3 months of ART, HbA1c tended to be 2 mmol/mol higher in the LNS supplemented group, most pronounced among those receiving whey as the protein source. LNS led to higher 30-min glucose (0.5 mmol/L, 95% CI 0.2, 0.8) and 120-min glucose (0.4 mmol/L, 95% CI 0.03, 0.8) and a > 50% increase in fasting insulin, HOMA-B and HOMA-IR compared to the non-supplemented.Conclusion: Among Ethiopian people with HIV initiating ART, short-term LNS intake increased glucose and insulin levels, and tended to increase HbA1c, potentially leading to more insulin resistance. Higher intake of carbohydrates with LNS could influence glycemic status. Whether these metabolic changes in early HIV treatment are beneficial or increase long-term risk of metabolic disorders needs to be explored.
AB - Background: Without high-quality nutritional support, there is a risk that people infected with human immunodeficiency virus (HIV) will replace lost muscle mass with fat mass when initiating antiretroviral therapy (ART). We have shown that lipid-based nutrient supplements (LNS) with whey or soy considerably increases lean mass among Ethiopian people with HIV starting ART. Here, we aim to assess the effects of LNS on insulin function and glucose metabolism.Methods: This is a secondary analysis of a randomized trial testing the effect of three-month supplementation with LNS containing whey (LNS/whey) or soy (LNS/soy) among people with HIV. LNS/whey and LNS/soy groups were combined and then were compared against the non-supplemented group. The outcomes were change in fasting plasma-glucose (FPG), and 30-min glucose and 120-min glucose after oral glucose tolerance test. We further assessed effect on glycated hemoglobin (HbA1c), fasting insulin, homeostatic model assessment index for beta-cell function (HOMA-B) and insulin resistance (HOMA-IR).Results: Of the 318 patients enrolled, 268 (84.3%) had available FPG and HbA1c and included. After 3 months of ART, HbA1c tended to be 2 mmol/mol higher in the LNS supplemented group, most pronounced among those receiving whey as the protein source. LNS led to higher 30-min glucose (0.5 mmol/L, 95% CI 0.2, 0.8) and 120-min glucose (0.4 mmol/L, 95% CI 0.03, 0.8) and a > 50% increase in fasting insulin, HOMA-B and HOMA-IR compared to the non-supplemented.Conclusion: Among Ethiopian people with HIV initiating ART, short-term LNS intake increased glucose and insulin levels, and tended to increase HbA1c, potentially leading to more insulin resistance. Higher intake of carbohydrates with LNS could influence glycemic status. Whether these metabolic changes in early HIV treatment are beneficial or increase long-term risk of metabolic disorders needs to be explored.
KW - Faculty of Science
KW - Lipid-based nutritional supplements
KW - Soy
KW - Whey
KW - Glucose
KW - Insulin
KW - HIV
KW - Ethiopia
U2 - 10.1186/s40795-021-00462-y
DO - 10.1186/s40795-021-00462-y
M3 - Journal article
C2 - 34657634
VL - 7
JO - B M C Nutrition
JF - B M C Nutrition
SN - 2055-0928
M1 - 60
ER -
ID: 282530109