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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1527936
This article is part of the Research Topic Digital Technology in the Management and Prevention of Diabetes: Volume II View all 5 articles

Nutritional Risk and HbA1c as Critical Risk Factors and Predictors of Opportunistic Infections in HIV-DM Comorbid Patients: A Retrospective Cross-Sectional Study

Provisionally accepted
Qiong'e Zhu Qiong'e Zhu 1Fengjiao Gao Fengjiao Gao 2*Xiaoxia Ren Xiaoxia Ren 2*Rui Li Rui Li 2*Jun Kang Jun Kang 2*Dafeng Liu Dafeng Liu 2*Maoquan Li Maoquan Li 1,3*
  • 1 Department of Public Health, Chengdu Medical College, Chengdu, Sichuan Province, China
  • 2 Public Health and Clinical Center of Chengdu, Chengdu, Sichuan Province, China
  • 3 Neijiang Health Vocational College, Neijiang, China

The final, formatted version of the article will be published soon.

    The clinical characteristics and risk factors for opportunistic infections in HIV patients with concomitant diabetes mellitus are unclear and worth studying. Explore the risk factors and construct a predictive model for opportunistic infections in HIV-DM patients.Clinical data were retrospectively collected from 1,669 HIV-DM admitted to the Public Health Clinical Center of Chengdu from December 2018 to November 2023.Based on the occurrence of opportunistic infections, the patients were divided into two groups.Comparative analyses were conducted to assess nutritional status, plasma glucose levels, comorbidities of chronic noncommunicable diseases, and immune status. We applied univariate logistic regression and LASSO regression to screen independent variables. Multivariable logistic regression analysis was performed to identify risk factors and establish a prediction model for opportunistic infections.In our study population of 1,669 patients (median age was 59 years, 83.22% male), 868 developed opportunistic infections, while the remaining 801 patients did not develop opportunistic infections. Additionally, 1,598 patients survived, and 71 patients died. The opportunistic infection group had a greater median age, lower median BMI, longer median length of hospital stay and greater number of deaths. Logistic regression analysis identified nutritional risk, duration of HIV infection, HbA1c, albumin, and CD4+ T cell counts as significant risk factors and predictors of opportunistic infections.Nutritional risk (OR=2.888) and HbA1c showed positive associations (P<0.001), while duration of HIV infection, albumin, and CD4+ T cell counts demonstrated negative associations with infection risk (P<0.05). The comprehensive model evaluation, based on receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA), validated the acceptable predictive performance of our model.This study identified nutritional risk, duration of HIV infection, HbA1c and albumin as significant risk factors and predictors of opportunistic infections in HIV-DM patients, further highlighting the importance of nutritional screening and good glucose control.

    Keywords: HIV, diabetes, Nutritional risk, Glycosylated hemoglobin, Opportunistic Infections

    Received: 14 Nov 2024; Accepted: 17 Dec 2024.

    Copyright: © 2024 Zhu, Gao, Ren, Li, Kang, Liu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Fengjiao Gao, Public Health and Clinical Center of Chengdu, Chengdu, 610061, Sichuan Province, China
    Xiaoxia Ren, Public Health and Clinical Center of Chengdu, Chengdu, 610061, Sichuan Province, China
    Rui Li, Public Health and Clinical Center of Chengdu, Chengdu, 610061, Sichuan Province, China
    Jun Kang, Public Health and Clinical Center of Chengdu, Chengdu, 610061, Sichuan Province, China
    Dafeng Liu, Public Health and Clinical Center of Chengdu, Chengdu, 610061, Sichuan Province, China
    Maoquan Li, Department of Public Health, Chengdu Medical College, Chengdu, Sichuan Province, China

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