(P24-029-23) Prevalence of and Factors Associated With Insulin Resistance Among People Living With HIV: Preliminary Findings From the NOURISH-OK Study

Objectives: People living with HIV (PLWH) are disproportionately affected by food insecurity (FI) and insulin resistance (IR). FI may increase the risk for IR through nutritional and non-nutritional pathways. The purpose of these preliminary analyses is to describe IR prevalence and explore its potential risk factors in a community-based sample of PLWH.

Methods: These analyses are from Aim 1 of NOURISH-OK, an ongoing study (goal enrollment=500). Survey measures included food security (10-item USDA), physical activity (PA), sleep duration, alcohol use (AUDIT-C), perceived stress (PSS-10), and smoking status. Dietary intake was estimated using a single day 24-hr food recall (ASA24). Objective measures included waist circumference (WC) and skin carotenoid concentration (Veggie Meter®). We defined high-risk WC as >40” (men) and >35” (women). We used QUICKI scores derived from fasting insulin and glucose levels to classify IR ( < 0.339). We compared demographics and risk factors by IR using t-tests for continuous variables and chi-squared tests for categorical variables on the first 190 enrolled participants.

Results: IR affected most participants (61.9%) and was common among all levels of food security (64.9% high, 55.3% marginal, 55.9% low, 67.4% very low, p=0.56). IR was more common among those >45 years than those <45 years (68.7% vs. 46.4%, p=0.004). Most participants with high-risk WC (84.9%) had IR, but one-third (33.7%) with low-risk WC also had IR (p < 0.0001). More of those with low PA had IR (70.3%) than those with moderate (48.7%) or high (44.4%) PA (p=0.007). We found no significant differences in IR for remaining variables. Although not significant, those with IR had lower Veggie Meter® scores (M=274.3 vs. M=289.8) as well as lower intake of dietary fiber (M=7.0 vs. 7.7 g/1,000 kcal) and higher intakes of solid fat (18.6 vs. 17.0 g/1,000 kcal) and added sugars (M=11.2 vs. 10.2 g/1,000 kcal).

Conclusions: IR was very common in this community-based sample of PLWH irrespective of FI status. Traditional risk factors, including increased WC, low PA, and age were associated with IR, but IR was also common among PLWH without these traditional risks. Future analyses will explore other candidate dietary and non-dietary predictors of IR among those not meeting traditional risk criteria.

Funding Sources: National Institute of Diabetes and Digestive and Kidney Diseases