Insulin resistance and associated factors among HIV-infected patients in sub-Saharan Africa: a cross sectional study from Cameroon

BACKGROUND: Little is known on the magnitude and correlates of insulin resistance in HIV-infected people in Africa. We determined the prevalence of insulin resistance and investigated associated factors in HIV-infected adult Cameroonians. METHODS: We conducted a cross-sectional study at the Yaoundé Central Hospital, Cameroon; during which we enrolled HIV-infected people aged 30 to 74 years with no previous history of cardiovascular disease. An homeostatic model assessment of insulin resistance (HOMA-IR) like index served to assess insulin sensitivity with insulin resistance defined by values of 2.1 or higher. RESULTS: We included 452 patients (20% men). Their mean age was 44.4 ± 9.8 years and 88.5% of them were on antiretroviral therapy (93.3% on first line regimen including Zidovudine, lamivudine and Efavirenz/Nevirapine). Of all participants, 28.5% were overweight, 19.5% had obesity and 2.0% had diabetes. The prevalence of insulin resistance was 47.3% without any difference between patients on ART and those ART-naïve (48.5% vs. 38.5%; p = 0.480). Obesity was the only factor independently associated with insulin resistance (adjusted odds ratio: 2.28; 95% confidence interval: 1.10-4.72). CONCLUSION: Insulin resistance is present in nearly half of HIV-infected patients in Cameroon despite a low prevalence rate of diabetes, and is associated with obesity

Active and passive tobacco smoking among students of the University of Yaoundé I, Cameroon

Background Tobacco smoking is a leading cause of preventable deaths globally. Although tobacco-induced burden has started decreasing in developed countries, it is continuously increasing in developing countries with young populations being mostly affected. This study aimed to determine the prevalence of active and passive smoking among youths in Cameroon. Methods This was a cross-sectional study carried-out from May-July 2017 at the University of Yaoundé I, Cameroon. We included any student registered at the University, found at one of the campuses when the investigators visited, and volunteering to participate. Smoking status was classified as never, former (last smoked more than 12 month ago) or current (smoked regularly in the last 12 months). Passive smoking was defined as a regular exposure to tobacco smoke since the last twelve months. Results Overall, 949 (54% males) were included in this study, with a median age of 23 years (interquartile range (IQR) 21-26). The prevalence of former, current and passive smoking was 3.4% (95% confidence interval (CI): 2.3-4.6), 0.8% (95%CI: 0.2-1.4), and 27.7% (95%CI: 24.9-30.6), respectively. Exposure to other people's smoke ranged from 1 to 50 hours per week, with a median of 1 hour/week (IQR 1-2). Those who smoked were more likely to be males (odds ratio (OR) 2.05, 95%CI: 1.03-4.08; p=0.037) and/or hazardous alcohol drinkers (OR 4.93, 95%CI: 2.55-9.52; p< 0.001). Similarly, males (OR 1.57, 95%CI: 1.18-2.11; p=0.002) and/or hazardous alcohol drinkers (OR 2.10, 95%CI: 1.55-2.86; p< 0.001) were more at risk of passive smoking. Conclusions Although the prevalence of active smoking seemed low in this population, almost one-third of students were passive smokers, reflecting a high burden of tobacco smoking in the general population. Therefore, regulations towards tobacco consumption should be reinforced in our country. Specifically, special laws banning and severely punishing smoking in public places should be voted and adopted

Atherogenic index of plasma and 10-year risk of cardiovascular disease in adult Africans living with HIV infection: A cross-sectional study from Yaoundé, Cameroon

Background The paucity of data regarding the association between atherogenic index of plasma and risk of cardiovascular disease in HIV-infected populations living in sub-Saharan Africa prompted us to conduct this study which aimed to assess the relationship between atherogenic index of plasma and risk of cardiovascular disease among a Cameroonian HIV-infected population. Methods This was a cross-sectional study conducted among 452 HIV-infected adults in Yaoundé, Cameroon. Risk of cardiovascular disease was calculated using the Framingham risk score; atherogenic index of plasma was derived as log (triglycerides/high-density lipoproteins cholesterol). Results Participants’ mean age (80% females) was 44.4 ± 9.8 years. Atherogenic index of plasma values ranged from –0.63 to 1.36 with a median of 0.11 (25th–75th percentiles: –0.08-0.31). Most participants (88.5%) were on antiretroviral treatment. There was a significant correlation between atherogenic index of plasma and fasting plasma glucose (r = 0.116; p  = 0.014), atherogenic index of plasma and total cholesterol (r = –0.164; p  < 0.001). Atherogenic index of plasma was significantly associated with the risk of cardiovascular disease either in univariable (β = 5.05, 95% CI: 3.31–6.79; p  < 0.001, R 2  = 0.067) or in multivariable linear regression model after adjusting for socio-demographic, clinical and biological confounders (adjusted β = 3.79, 95% CI: 1.65 – 4.88; p  < 0.001, R 2  = 0.187). Conclusion Atherogenic index of plasma may be an independent factor impacting the risk of cardiovascular disease among Cameroonian HIV-infected people. More studies are needed to better elucidate the association between atherogenic index of plasma and risk of cardiovascular disease in our setting