Metabolic Syndrome Predicts Reduced Neurocognitive Function in Patients With HIV

Metabolic syndrome is an independent predictor of reduced neurocognitive function in both Hispanic and non-Hispanic White older patients with HIV infection, according to study results published in AIDS Patient Care and STDs.

Researchers conducted a cross-sectional study between June 2015 and December 2018 to assess the role of race/ethnicity in neurocognition among older patients with HIV infection and whether neurocognitive function differs by the presence of metabolic syndrome. Eligible patients were aged 50 years and older who identified as either Hispanic or non-Hispanic White. Sociodemographic characteristics, neurocognition, HIV disease, metabolic syndrome, psychiatric and substance use disorders, and culturally relevant factors were all characterized and assessed. Differences between Hispanic and non-Hispanic White patients were evaluated via t-testing and chi-squared testing. The researchers also used logistic regression and univariable linear regression models for statistical analysis.

The final analysis included 116 community-dwelling patients with HIV infection, of whom 58 were Hispanic and 58 were non-Hispanic White. Among patients in these groups, the mean ages were 57.33 and 58.62 years, 58.62% and 56.90% had AIDS, 93.10% and 94.83% reported use of antiretroviral therapy, and the mean duration of reported education was 12.24 and 14.31 years, respectively.

Between-group analysis showed that Hispanic patients had significantly worse global neurocognition than non-Hispanic White patients (Cohen d, 0.56; P <.01), as well as lower learning and memory and visual-spatial skill scores. Moreover, Hispanic patients also exhibited significantly higher rates of metabolic syndrome (56% vs 38%; odds ratio, 2.13; 95% CI, 1.01-4.53; P <.05) and marginally higher rates of central obesity and increased triglyceride levels.

A stepwise regression model that included adjustments for race/ethnicity and other significant covariates demonstrated that Hispanic ethnicity was a significant predictor of worse global neurocognitive function (B, 3.82; P <.01).

Further analysis after adjustment for the presence of metabolic syndrome indicated that worse global neurocognitive function was independently associated with both Hispanic ethnicity (B, 3.39; P <.01) and metabolic syndrome (B, 2.73; P <.04).

Limitations of this study include the cross-sectional design, potential sources of error and bias, the possibility of reduced generalizability to Hispanics patients from other heritages or geographic regions, and the lack of data on certain biomarkers related to cardiovascular disease risk burden.

“[M]etS [metabolic syndrome] is a potentially important target to consider in the development of prevention and treatment efforts to ameliorate neurocognitive dysfunction among older PWH [people with HIV] of ethnically diverse backgrounds,” the researchers concluded.

Disclosure: One study author declared affiliations with pharmaceutical, biotech, and/or device companies. Please see the original reference for a full list of disclosures.

This article originally appeared on Infectious Disease Advisor