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: â=0.12-0.23, p<0.01; HIV-infected â=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.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-12022009-140249 |
| Date | 27 January 2010 |
| Creators | Longenberger, Allison |
| Contributors | Trevor Orchard, Jennifer Brach, Maria Mori Brooks, Lawrence A. Kingsley, Kristen Mertz |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-12022009-140249/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
Page generated in 0.0014 seconds