Page 283 - HIVMED_v21_i1.indb

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 8 Original Research

The spectrum of electrolyte abnormalities in black

African people living with human immunodeficiency

virus and diabetes mellitus at Edendale Hospital,

Pietermaritzburg, South Africa

Authors: Background: Serum electrolyte abnormalities in black African people living with human
Preyanka Pillay immunodeficiency virus (HIV) and diabetes mellitus (PLWH/DM) is unknown.
1,2
Somasundram Pillay
3,4
5,6
Nobuhle Mchunu
Objectives: The aim of this study was to analyse serum electrolytes (sodium, potassium,
Affiliations: calcium and phosphate) and factors associated with electrolyte abnormalities in black African
1 Department of Internal PLWH/DM versus HIV-uninfected patients with DM.
Medicine, Greys Hospital,
Pietermaritzburg, Methods: We conducted a retrospective case-control study in 96 black African PLWH/DM
South Africa
(cases) and 192 HIV-uninfected patients with DM (controls), who were visiting the Edendale
2 School of Clinical Medicine, Hospital DM clinic, from 01 January 2016 to 31 December 2016. Pearson’s correlation,
College of Health Sciences, multivariate linear and logistic regression analyses were utilised.
University of KwaZulu-Natal,
Durban, South Africa Results: Hypocalcaemia was the most frequent electrolyte abnormality in PLWH/DM and
HIV-uninfected patients with DM (31.25% vs. 22.91%), followed by hyponatraemia (18.75%
3 Department of Internal vs. 13.54%). Median (IQR) corrected serum calcium levels were significantly lower in
Medicine, Edendale Hospital,
Pietermaritzburg, PLWH/DM compared with HIV-uninfected patients with DM (2.24 [2.18–2.30] mmol/L vs.
South Africa 2.29 [2.20–2.36] mmol/L; p = 0.001). For every per cent increase in glycated haemoglobin, the
odds of hyponatraemia significantly increased in both PLWH/DM (odds ratio [OR]: 1.55;
4 Department of Internal
Medicine, King Edward 95% confidence interval [CI]: 1.19 –2.02; p = 0.003) and HIV-uninfected patients with DM
Hospital, Durban, (OR: 1.26; 95% CI: 1.04 –1.54; p = 0.009).
South Africa
Conclusion: Hypocalcaemia and hyponatraemia were the most frequent electrolyte
5 Department of Biostatistics, abnormalities and occurred more frequently in PLWH/DM compared with HIV-uninfected
Faculty of Statistics, South patients with DM. People living with HIV and DM have significantly lower corrected
African Medical Research
Council, Durban, South Africa serum calcium levels compared with HIV-uninfected patients with DM. Furthermore,
hyponatraemia is a marker of impaired glycaemic control.
6 Department of Statistics,
School of Mathematics, Keywords: HIV; diabetes mellitus; electrolytes; sodium; potassium; calcium; phosphate;
Statistics and Computer black African.
Science, University of
KwaZulu-Natal,
Pietermaritzburg,
South Africa Introduction
1
Corresponding author: Low- and middle-income countries account for 80% of the global diabetes mellitus (DM) burden.
Preyanka Pillay, The International Diabetes Federation (IDF) estimates that Africa will experience the greatest
[email protected] global upsurge of DM by 2045. In 2015, DM was the second leading cause of mortality in
1
2
Dates: South Africa after tuberculosis. Moreover, South Africa has the highest prevalence of human
Received: 26 Apr. 2020 immunodeficiency virus (HIV) globally and recorded 7.06 million people living with HIV (PLWH)
Accepted: 07 June 2020 in 2017, with KwaZulu-Natal province having the majority of these cases. Following the
3,4
Published: 23 July 2020
introduction of antiretroviral therapy (ART), the prevalence of comorbid HIV and DM is on the
5
rise because of an increase in life expectancy and the adverse metabolic effects of ART. A study
in the United States of America (USA) determined that the prevalence of DM in PLWH was
10.3%, and the prevalence of DM was 3.8% higher in PLWH compared with the general
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Copyright: © 2020. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
http://www.sajhivmed.org.za 275 Open Access