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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 林先和(Hsien-Ho Lin) | |
dc.contributor.author | Chia-Yun Chung | en |
dc.contributor.author | 鍾佳芸 | zh_TW |
dc.date.accessioned | 2021-06-15T14:02:00Z | - |
dc.date.available | 2015-09-14 | |
dc.date.copyright | 2015-09-14 | |
dc.date.issued | 2015 | |
dc.date.submitted | 2015-08-20 | |
dc.identifier.citation | 1. WHO. HIV/AIDS. 2014 July 2014; ,]. Available from: http://www.who.int/mediacentre/factsheets/fs360/en/.
2. 衛生福利部疾病管制署, 愛滋病檢驗治療指引 - 疾病管制局. 4 ed. 2013: 衛生福利部疾病管制署. 3. Carr, A., et al., Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor-associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet, 1999. 353(9170): p. 2093-9. 4. Chene, G., et al., Role of long-term nucleoside-analogue therapy in lipodystrophy and metabolic disorders in human immunodeficiency virus-infected patients. Clin Infect Dis, 2002. 34(5): p. 649-57. 5. Seaberg, E.C., et al., Association between highly active antiretroviral therapy and hypertension in a large cohort of men followed from 1984 to 2003. AIDS, 2005. 19(9): p. 953-60. 6. 林咏臻, et al., 服用雞尾酒療法之愛滋病毒感染者其慢性病盛行率與發生率之探討. Taiwan Public Health Association,, 2011. 30(6): p. 549-557. 7. Galescu, O., A. Bhangoo, and S. Ten, Insulin resistance, lipodystrophy and cardiometabolic syndrome in HIV/AIDS. Rev Endocr Metab Disord, 2013. 14(2): p. 133-40. 8. Tien, P.C., et al., Antiretroviral therapy exposure and insulin resistance in the Women's Interagency HIV study. J Acquir Immune Defic Syndr, 2008. 49(4): p. 369-76. 9. Rao, M.N., K. Mulligan, and M. Schambelan, HIV Infection and Diabetes. 2010: p. 617-642. 10. Hall, V., et al., Diabetes in Sub Saharan Africa 1999-2011: epidemiology and public health implications. A systematic review. BMC Public Health, 2011. 11: p. 564. 11. Kim, D.J., et al., Multimorbidity patterns in HIV-infected patients: the role of obesity in chronic disease clustering. J Acquir Immune Defic Syndr, 2012. 61(5): p. 600-5. 12. WHO. Coverage and need for antiretroviral treatment (ART). 2009; Available from: http://www.who.int/hiv/data/coverage2008/en/. 13. Global Burden of Disease Study, C., Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2015. 14. in The Continuing Epidemiological Transition in Sub-Saharan Africa: A Workshop Summary. 2012: Washington (DC). 15. Calza, L., et al., Prevalence of diabetes mellitus, hyperinsulinaemia and metabolic syndrome among 755 adult patients with HIV-1 infection. Int J STD AIDS, 2011. 22(1): p. 43-5. 16. Omech, B., et al., Prevalence of HIV-Associated Metabolic Abnormalities among Patients Taking First-Line Antiretroviral Therapy in Uganda. ISRN AIDS, 2012. 2012: p. 960178. 17. C, G., et al., Hypertension among HIV patients: prevalence and relationships to insulin resistance and metabolic syndrome. J Hypertens, 2003. 21(7): p. 1377-82. 18. Kroll, A.F., et al., Prevalence of obesity and cardiovascular risk in patients with HIV/AIDS in Porto Alegre, Brazil. Arq Bras Endocrinol Metabol, 2012. 56(2): p. 137-41. 19. Crum-Cianflone, N., et al., Obesity among patients with HIV: the latest epidemic. AIDS Patient Care STDS, 2008. 22(12): p. 925-30. 20. Kagaruki, G.B., et al., Magnitude and risk factors of non-communicable diseases among people living with HIV in Tanzania: a cross sectional study from Mbeya and Dar es Salaam regions. BMC Public Health, 2014. 14: p. 904. 21. WHO, WHO STEPS Surveillance: Malawi National STEPS Survey for Chronic Non-Communicable Diseases and their Risk Factors. 2010. 22. WHO. WHO STEPS Surveillance: Training and Practical Guides (Section 3). 2008 12 December 2008; Available from: http://www.who.int/chp/steps/manual/en/index3.html. 23. WHO, WHO STEPS Surveillance: Training and Practical Guides (Section 4), W.H. Organization, Editor. 2008. 24. Israel, G.D. Determining Sample Size. 2009. 25. WHO. Overweight and obesity. 2014; Available from: http://www.who.int/gho/ncd/risk_factors/overweight/en/. 26. ADA. Diagnosing Diabetes and Learning About Prediabetes. 2014 March 27, 2014; Available from: http://www.diabetes.org/diabetes-basics/diagnosis/?loc=db-slabnav. 27. Ministry of Health in Malawi, Clinical management of HIV in children and adults, Ministry of Health, Editor. 2011. 28. Dillon, D.G., et al., Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: a systematic review and meta-analysis. International Journal of Epidemiology, 2013. 42: p. 1754-1771. 29. Grinspoon, S. and A. Carr, Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med, 2005. 352(1): p. 48-62. 30. Alencastro, P.R., et al., Characteristics Associated to Lipodystrophy Syndrome among HIVInfected Patients Naive and on Antiretroviral Treatment. J AIDS Clinic Res, 2012. 3(9). 31. Malawi 2010: results from the demographic and health survey. Stud Fam Plann, 2012. 43(2): p. 147-52. 32. WHO, Life tables by country-Malawi. 2014. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/51996 | - |
dc.description.abstract | 背景與目標:隨著抗反轉錄病毒療法(ART)效益的提高和及早開始服用ART的建議,感染人類免疫缺陷病毒(HIV)患者的平均餘命可預期地大幅改善。另一方面,終身使用ART可能導致若干代謝問題,包括肥胖,糖尿病,和高血壓。到目前為止,馬拉威感染愛滋病毒的族群中,肥胖、糖尿病和高血壓的盛行狀況還不清楚。
方法:我們在馬拉威北部的姆祖祖中心醫院,針對感染HIV成年人且正使用ARV治療的患者進行一橫斷性研究。研究期間,每位至愛滋門診追蹤的病人皆會被邀請參與研究,總參與率為97.2%。病人知情同意後,受訓過的現場工作人員開始進行身體測量,血壓檢查,及指尖採血測試血糖。我們依據世界衛生組織(WHO)和美國糖尿病協會的標準來定義肥胖,高血壓,糖尿病。我們將本研究結果與WHO於2009年在馬拉威進行之全國性的調查結果(Stepwise approach to surveillance, STEPS)進行比較。 結果:研究共收集410位參與者資料(男性佔21.0%)。肥胖(BMI (Body mass index)≥30)和體重過重(25≤ BMI <30)的男女性別盛行率分別為男性2.3%(95%CI:0.0-5.5%)和8.1% (95%CI:2.4-13.9%),女性12.0%(95%CI:8.5-15.6%)和26.9%(95%CI:22.0-31.7%)。肥胖和體重過重的情況在女性的盛行皆高於男性。另外,年齡(OR:1.7,95%CI:1.2-2.5)和持續飲酒習慣(OR:5.9,95%CI:2.1-16.1)兩因子,顯著與肥胖相關。高血壓的盛行率為18.1%(95%CI:14.1-21.5%),蔬菜攝取量與此研究族群的高血壓盛行率相關(OR:0.9,95%CI:0.8-1.0)。糖尿病和空腹血糖異常的盛行率分別為2.9%(95%CI:1.3-4.6%)及17.8%(95%CI:10.9-24.7%)。比較調整後的疾病盛行率和STEPS調查結果,本研究呈現較高的肥胖盛行率(8.6% vs. 4.6%)和空腹血糖異常(15.1% vs. 4.2%),較低的高血壓(19.4% vs. 32.9%)和相似的糖尿病(4.4% vs. 5.6%)盛行率。這群愛滋病患有26.1%(95%CI:21.9-30.4%)至少有一項慢性疾病〈肥胖和/或高血壓和/或糖尿病〉同時存在。 結論與討論:我們的研究提供了在馬拉威針對HIV感染人群中長期使用抗反轉錄病毒療法下,代謝危險因子的疾病負擔。代謝危險因子的盛行在這族群是值得關注的問題。長期對非傳染性疾病負擔的影響需要更進一步調查。 | zh_TW |
dc.description.abstract | Background: With increased availability of antiretroviral therapy (ART), the life expectancy of people with human immunodeficiency virus (HIV) infection is expected to improve substantially. On the other hand, life-long ART may be associated with increased obesity, diabetes, and hypertension. The situation of obesity, diabetes, and hypertension in HIV-infected population in Malawi is unclear. We aim to conduct a survey to gain the prevalence of metabolic risk factors among HIV under ART patients.
Methods: We conducted a cross-sectional study including adult HIV-infected patients under ART treatment in a teaching hospital from northern Malawi. All patients who received follow-up at the HIV care and treatment clinic were invited, and the participation rate was 97.2%. After acquiring informed consent, trained field workers performed anthropometric measurements, blood pressure exam, and finger prick test for blood glucose. The prevalence of metabolic risk factors were compared to our study population by the 2009 stepwise approach to surveillance (STEPS) approach in Malawi. Results: This study included 410 participants (21.0% males). The prevalence of obesity (Body mass index (BMI)≥30) and overweight (25≤BMI<30) were 2.3% (95%CI: 0.0-5.5%) and 8.1% (95%CI: 2.4-13.9%) in males, and 12.0% (95%CI: 8.5-15.6%) and 26.9% (95%CI: 22.0-31.7%) in females. There were 18.1% (95% CI: 14.3-21.8%) diagnosed as hypertension. The prevalence of dysglycemia (19.5%, 95% CI: 18.4-20.6%) was higher than that in STEPS survey (9.8%). Old age was the common predictive factor, and significantly associated with these diseases. The comorbidity occupied 26.1% (95%CI: 21.9-30.4%) of all patients. Conclusion: Our study provides an initial assessment of the burden of metabolic risk factors among HIV-infected population under long-term ART treatment in Malawi. The high prevalence of metabolic risk factors in this population need more concerning. Long-term impact of ART treatment on the burden of non-communicable diseases warrants further investigation. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T14:02:00Z (GMT). No. of bitstreams: 1 ntu-104-P02849004-1.pdf: 677680 bytes, checksum: 013e4089cff658cc75eb6d8d4bc19f4e (MD5) Previous issue date: 2015 | en |
dc.description.tableofcontents | Table of Contents
Chapter 1 Introduction 1 Chapter 2 Methods 2 2.1 Study design and study population 2 2.2 Data collection 2 2.2.1 Training of field workers 2 2.2.2 Recruitment of participants 3 2.2.3 Power calculation 4 2.2.4 Data Processing 4 2.3. Outcome measurements 5 2.4. Statistical analysis 5 2.5 Ethics statement 6 Chapter 3 Results 6 3.1 Characteristics of participants 6 3.2 Overweight, obesity, and central obesity 7 3.3 Hypertension 8 3.4 Diabetes mellitus and dysglycemia 9 3.5 Comparison with the STEPS survey 9 Chapter 4 Discussions 10 4.1 Sex ratio in this study 10 4.2 Comparison with previous studies 11 4.2.1 Obesity 11 4.2.2 Hypertension 12 4.2.3 Diabetes mellitus and dysglycemia 13 4.3 Limitation of the study 14 4.4 Public health implications 15 4.5 Implication on global health education and research in NTU 16 Chapter 5 Conclusion 17 Reference 18 Table Table 1. Characteristics of 410 HIV-infected participants under ART (antiretroviral therapy) 22 Table 2. Univariable and multivariable analysis of the predictors of obesity among HIV-infected participants under antiretroviral therapy (ART) 24 Table 3. Compare the prevalence in this study with Stepwise approach to surveillance (STEPS) in 2009 25 Table 4. Univariable and multivariable analysis of the predictors of hypertension among HIV-infected participants under antiretroviral therapy (ART) 26 Table 5. Univariable and multivariable analysis of the predictors of diabetes among HIV-infected participants under antiretroviral therapy (ART) 27 Appendix Table 1. Prevalence of NCD (non-communicable disease) in HIV-infected patients under antiretroviral therapy (ART) 28 Table 2. Characteristics of 410 HIV-infected participants under ART (antiretroviral therapy) - Demographic information 29 | |
dc.language.iso | en | |
dc.title | 馬拉威北部使用抗反轉錄病毒療法之愛滋病患者在代謝危險因子之盛行率 | zh_TW |
dc.title | Prevalence of metabolic risk factors in HIV-infected population under antiretroviral therapy in northern Malawi | en |
dc.type | Thesis | |
dc.date.schoolyear | 103-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 方啟泰(Chi-Tai Fang),詹長權(Chang-chuan Chan),楊靖慧(Chin-Hui Yang) | |
dc.subject.keyword | 人類免疫缺陷病毒,抗反轉錄病毒療法,代謝性疾病,非傳染性慢性病,馬拉威, | zh_TW |
dc.subject.keyword | HIV,antiretroviral therapy (ART),metabolic risk factors,non-communicable diseases (NCD),Malawi, | en |
dc.relation.page | 31 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2015-08-20 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 流行病學與預防醫學研究所 | zh_TW |
顯示於系所單位: | 流行病學與預防醫學研究所 |
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