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Insulin Sensitivity of Term Newborns Exposed in Utero to HIV and Antiretrovirals in Yaoundé

Open Journal of Endocrine and Metabolic Diseases 2023年第9期13卷 161-172页

作者： Francine Mendane Ekobena audrey christance donfack Hortence Fouedjio Suzanne Ngo Um Sap Martine Claude Etoa Etoga Mesmin Dehayem Anne Boli Ongmeb Gabriel Loni Ekali Jean Claude Mbanya Eugène Sobngwi Internal Medicine Unit Essos Hospital Center Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Obstetrics and Gynecology Unit Yaoundé Central Hospital Yaoundé Cameroon Mother and Child Center Chantal Biya Foundation Yaoundé Cameroon Endocrinology and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Health Sciences of Bamenda Bamenda Cameroon Biotechnology Center University of Yaoundé 1 Yaoundé Cameroon

Introduction: Antiretrovirals (ARVs) and the human immunodeficiency virus (HIV) are implicated in the onset of insulin resistance. They cross the placental barrier thereby inducing early modifications of the fetal environment. The aim of our study was to assess insulin sensitivity in full-term newborns exposed in utero to HIV and ARVs in Yaoundé. Materials and Methods: We conducted an analytical cross-sectional study in 2 maternities in the city of Yaoundé from November 2021 to June 2022. We generated two groups of newborns (NBs): one group born to HIV positive mothers on ARVs and the other control group born to HIV negative mothers. Clinical data from mothers and NBs were collected. A homeostatic model assessment of insulin resistance (HOMA-IR) like index with C peptide served to assess insulin sensitivity. We used the Spearman correlation to measure the strength of association between insulin sensitivity and the different variables. A p-value Results: Of 70 neonates included, 35 were born to HIV positive mothers on ARVs and 35 to HIV negative mothers. The median age of HIV positive and negative mothers was 30 (27 - 32) and 34 (24 - 47) years, respectively (p = 0.791). The body mass index before pregnancy as well as the average newborn weights were comparable in both groups. The ARV protocol associating Tenofovir, Lamivudine, Efavirenz was used by 97.1% of HIV positive mothers. In the exposed NBs group, C peptide was significantly lower (p < 0.001) and blood glucose significantly higher (p < 0.001). The median values of HOMA-IR were 1.4 (0.8 - 1.9) and 2 (1.4 - 2.6) (p = 0.001) for exposed and unexposed NBs, respectively. Conclusion: Newborns exposed to HIV and ARVs had lower C peptide levels and were more sensitive to insulin. Close metabolic monitoring of these newborns would allow early diagnosis and management of any glucose regulation disorder.

关键词： Insulin Sensitivity Newborns Antiretrovirals HIV C Peptide HOMA-IR

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