{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T12:04:46Z","timestamp":1759147486714,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T00:00:00Z","timestamp":1571788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["K23HD088295\u201001A1"],"award-info":[{"award-number":["K23HD088295\u201001A1"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R21DK118757"],"award-info":[{"award-number":["R21DK118757"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The risk of cardiometabolic complications in children with perinatally acquired HIV infection (PHIVs) and in perinatally HIV\u2010exposed but uninfected children (HEUs) and its relationship to systemic inflammation and markers of gut integrity are not well established. In this current study, we assed insulin resitance in PHIV compared to HEUs and HIV unexposed uninfected children and explored potential association with intestinal damage biomarkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cross\u2010sectional study in PHIVs, HEUs and HIV\u2010unexposed, uninfected children (HUUs) aged 2\u201310\u00a0years enrolled in Uganda. PHIVs were on stable antiretroviral therapy (ART) with HIV viral load \u00a0&lt;\u00a0400 HIV\u20101 RNA copies\/mL. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA\u2010IR). We measured markers of systemic inflammation, monocyte activation and gut integrity. Kruskal\u2013Wallis tests were used to compare markers by HIV status; Pearson correlation and multiple linear regressions were used to assess associations of the HOMA\u2010IR index with biomarkers of intestinal damage and translocation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 172 participants were enrolled in the study (57 PHIVs, 59 HEUs and 56 HUUs). The median age was 7.8 [interquartile range (IQR) 6.39, 8.84] years, 55% were female and the median body mass index (BMI) was 15 (IQR 14.3, 15.8) kg\/m<jats:sup>2<\/jats:sup>. Among PHIVs, the median CD4% was 37%, and 93% had viral load \u2264\u00a020 copies\/mL. PHIVs had higher waist:hip ratio, high\u2010density lipoprotein (HDL) cholesterol, triglycerides and HOMA\u2010IR index than the other groups (<jats:italic>P<\/jats:italic>\u00a0\u2264\u00a00.02). Factors correlated with insulin resistance included higher BMI and HDL cholesterol and lower soluble tumour necrosis factor receptor I (sTNFRI) (<jats:italic>P<\/jats:italic>\u00a0\u2264\u00a00.02). There was no correlation between any of the other inflammatory or gut biomarkers and HOMA\u2010IR index (<jats:italic>P<\/jats:italic>\u00a0\u2265\u00a00.05). After adjusting for age and sTNFRI, BMI remained independently associated with the HOMA\u2010IR index (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.16; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite viral suppression, Ugandan PHIVs have disturbances in glucose metabolism. Higher BMI, and not immune activation or alteration of gut integrity, was associated with insulin resistance in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12808","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T19:08:08Z","timestamp":1571857688000},"page":"119-127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Insulin resistance and intestinal integrity in children with and without HIV infection in Uganda"],"prefix":"10.1111","volume":"21","author":[{"given":"S","family":"Dirajlal\u2010Fargo","sequence":"first","affiliation":[{"name":"University Hospitals Cleveland Medical Center Cleveland OH USA"},{"name":"Rainbow Babies and Children\u2019s Hospital Cleveland OH USA"},{"name":"Case Western Reserve University Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Shan","sequence":"additional","affiliation":[{"name":"Case Western Reserve University Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Sattar","sequence":"additional","affiliation":[{"name":"Case Western Reserve University Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Bowman","sequence":"additional","affiliation":[{"name":"Ohio State University School of Health and Rehabilitation Sciences Columbus OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Gabriel","sequence":"additional","affiliation":[{"name":"Ohio State University School of Health and Rehabilitation Sciences Columbus OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Ohio State University School of Health and Rehabilitation 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