Metabolic Syndrome and Neurocognitive Deficits in HIV Infection

Abstract

Background: The adverse consequences of HIV and related comorbidities on the central nervous system remain prevalent in the era of combination antiretroviral therapy. Metabolic syndrome (MetS) is a common comorbidity in HIV and has been linked to increased neurocognitive impairment in the general population. We investigated the association between MetS and neurocognition among persons living with HIV (PLHIV). Methods: Participants included 109 PLHIV and 92 HIV-uninfected adults (HIV2) from the Multi-dimensional Successful Aging cohort study at the University of California San Diego (age: M = 50.8, SD = 8.0). Participants completed neuromedical, psychiatric, and neurocognitive assessments. Based on a comprehensive neurocognitive battery, we examined global neurocognitive deficits (based on the entire battery) and neurocognitive deficits in 7 domains (verbal fluency, learning, recall, executive function, working memory, speed of information processing, and fine motor skills). MetS was determined via the standard criteria by the National Cholesterol Education Program's Adult Treatment Panel-III. Covariates examined included demographics and psychiatric comorbidities (and HIV disease characteristics among PLHIV). Results: MetS had an independent significant effect on global neurocognitive deficits among PLHIV (P = 0.03) but not among their HIV2 counterparts (P = 0.93). Among PLHIV, MetS was most strongly associated with the neurocognitive domains of learning, fine motor skills, and executive function. Diabetes and elevated triglycerides were the MetS components most strongly linked with increased global neurocognitive deficits in PLHIV. Conclusions: The present findings underscore the need for early identification of PLHIV at risk for MetS and the implementation of preventive and treatment approaches to lessen the development of MetS and neurocognitive impairment among PLHIV.

COMT Val158Met Polymorphism, Cardiometabolic Risk, and Nadir CD4 Synergistically Increase Risk of Neurocognitive Impairment in Men Living With HIV

“…PLWH are at greater risk of cardiometabolic complications (i.e., hypertension, dyslipidemia, diabetes, and obesity) possibly due to HIV-related accelerated biological aging and iatrogenic consequences of cART 10,11 . Cardiometabolic risk contributes to NCI by triggering an array of neuro-compromising processes, including increased bloodbrain-barrier permeability, chronic inflammation, and endothelial dysfunction [12][13][14][15][16] .…”

Association of HIV serostatus and metabolic syndrome with neurobehavioral disturbances

“…Among PLWH, MetS is highly prevalent (Jacobson et al 2006;Martin-Iguacel et al 2016) and there is evidence that its impact on neurocognitive impairment might be even more notable among PLWH than in the general population (Yu et al 2019), possibly because of the impact of MetS on blood-brain barrier integrity and systemic inflammation (Gustafson et al 2007;Sattler et al 2015). Aside from MetS, neurocognitive impairment is prevalent in HIV, occurring in approximately 40% of PLWH (Heaton et al 2010).…”

Predictors of metabolic syndrome among people living with HIV in the Gedeo-Zone, Southern-Ethiopia: an unmatched case-control study

“…Metabolic syndrome (MS) is the risk markers of NCDs, usually diagnosed based on the following medical conditions: abdominal obesity, elevated blood pressure (BP), elevated fasting plasma glucose, high serum triglycerides (TG), and low high-density lipoprotein (HDL) cholesterol levels [4,[14][15][16][17]].…”