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MEASURES OF PHYSICAL FUNCTION AS RISK FACTORS FOR DIABETES MELLITUS AND INSULIN RESISTANCE AMONG HIV-UNINFECTED AND HIV-INFECTED MEN

Longenberger, Allison (2010) MEASURES OF PHYSICAL FUNCTION AS RISK FACTORS FOR DIABETES MELLITUS AND INSULIN RESISTANCE AMONG HIV-UNINFECTED AND HIV-INFECTED MEN. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Physical activity is an accepted intervention for the prevention of diabetes mellitus (DM) and insulin resistance (IR) in the general population. Few studies in HIV-infected persons assessed the role of physical function or physical activity as a contributing factor to glucose disorders. The relationship between self-reported and performance-based measures of physical function in HIV-infected individuals has not been assessed. This dissertation examined associations between self-reported and performance-based measures of physical function, DM, and IR in HIV-uninfected and HIV-infected men.Data from 658 men from the Pitt Men¡¦s Study were analyzed to assess the contribution of self-reported physical function to prevalent DM and IR. Physical function score (AOR 1.5 per 25 unit decrease, p=0.02) was significantly associated with diabetes, but not IR, after adjustment for covariates. Data from 1790 men from the Multicenter AIDS Cohort Study (MACS) were used to assess physical function as a risk factor for incident DM and IR. Cumulative DM incidence was highest among HIV-uninfected and HIV-infected men with low physical function. Low physical function was a risk factor for incident DM in HIV-uninfected men using more stringent (HR 1.31; 95% CI 1.02-1.66) and less stringent (HR 1.29; 95% CI 1.11-1.50) diabetes definitions adjusting for BMI, family history of diabetes and race. Among HIV-infected men, physical function was a risk factor for incident DM using the less stringent diabetes definition. To assess the relationship between self-reported and performance-based measures of physical function, DM and IR, a cross-sectional study of 2079 men from the MACS was conducted. Self-reported physical function and performance-based measures correlated weakly. (HIV-uninfected: ƒâ=0.12-0.23, p<0.01; HIV-infected ƒâ=0.16-0.24, p<0.01). Self-reported physical function had a stronger association with DM and IR than performance-based measures in HIV-uninfected but not HIV-infected men.There are important public health implications of this dissertation. Low physical function is a risk factor for DM in two cohorts of HIV uninfected and HIV-infected men; therefore interventions to increase physical function may decrease DM risk while simultaneously reducing the risk of further disability and chronic sequelae among HIV-infected individuals already diagnosed with diabetes. This is essential given the national burden of HIV infection and DM.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Longenberger, Allisonsroyal99@yahoo.com
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairKingsley, Lawrence Akingsley@pitt.eduKINGSLEY
Committee ChairOrchard, Trevortjo@pitt.eduTJO
Committee MemberBrach, Jenniferjbrach@pitt.eduJBRACH
Committee MemberMertz, Kristenmertzk@edc.pitt.eduKJM40
Committee MemberBrooks, Maria Moribrooks@edc.pitt.eduMBROOKS
Date: 27 January 2010
Date Type: Completion
Defense Date: 20 November 2009
Approval Date: 27 January 2010
Submission Date: 2 December 2009
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 167
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: AIDS; Multicenter AIDS; physical activity; Pitt Men's Study; Type 2; Cohort Study; human immunodeficiency virus
Other ID: http://etd.library.pitt.edu/ETD/available/etd-12022009-140249/, etd-12022009-140249
Date Deposited: 10 Nov 2011 20:07
Last Modified: 19 Dec 2016 14:37
URI: http://d-scholarship.pitt.edu/id/eprint/9963

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