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(Unpublished)
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
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| 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: |
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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