학술논문
Body Mass Index and Leptin Are Related to Cognitive Performance Over 10 Years in Women With and Without HIV Infection
Clinical Research Article
Clinical Research Article
Document Type
Academic Journal
Author
Source
Journal of Clinical Endocrinology & Metabolism. March 2022, Vol. 107 Issue 3, pe1126, 10 p.
Subject
Language
English
ISSN
0021-972X
Abstract
Improved antiretroviral therapies (ARTs) transformed HIV infection into a treatable chronic condition, increasing life expectancy among people living with HIV (PLWH) (1, 2). Consequently, PLWH may experience concomitant physiological and [...]
Context: It is not yet understood whether people living with HIV infection have an increased risk of Alzheimers Disease and Related Dementias due to enhanced survivorship with highly effective a nti retroviral therapies and/or increasing adiposity with aging. Objective: This work aimed to determine whether body mass index (BMI) and leptin were longitudinally associated over 10 years with neuropsychological performance (NP) among middle-aged women with HIV (WWH) vs without HIV. Methods: Women's Interagency HIV Study (WIHS) participants (301 WWH, 113 women without HIV from Brooklyn, NewYork City, and Chicago had baseline and 10-year BMI and fasting plasma leptin levels using commercial enzyme-linked immunosorbent assay (ng/mL); and demographically adjusted NP Tscores (attention/working memory, executive function [EF], processing speed, memory, learning, verbal fluency, motor function, global) at 10-year follow-up. Multivariate linear regression analyses, stratified by HIV serostatus, examined associations between BMI, leptin, and NR Results: Over 10 years, women (baseline age 39.8 [+ or -] 9.2 years, 73% Black, 73%WWH) transitionedfromaverageoverweight(29.1 [+ or -]7.9)toobese(30.5[+ or -] 7.9) BMI. Leptin increased 11.4 [+ or -] 26.4 ng/mL (P< .001). Higher baseline BMI and leptin predicted poorer 10-year EF among all women (BMI (3 = -6.97, 95% CI (-11.5 to -2.45) P=.003; leptin (3 = -1.90, 95% CI (-3.03 to -0.76), P = .001); higher baseline BMI predicted better memory performance (|3 = 6.35,95% CI (1.96-10.7), P = .005). Greater 10-year leptin increase predicted poorer EF (P = .004), speed (P= .03), and verbal (P= .02) and global (P= 0.005) performance among all women, and WWH. Greater 10-year BMI increase predicted slower processing speed (P= .043) among all women; and among WWH, poorer EF (P= .01) and global (P= .04) performance. Conclusion: In middle-aged WIHS participants, 10-year increases in BMI and leptin were associated with poorer performance across multiple NP domains among all women and WWH. Trajectories of adiposity measures over time may provide insight into the role of adipose tissue in brain health with aging. Key Words: cognition, leptin, HIV, women, overweight, obesity, body mass index
Context: It is not yet understood whether people living with HIV infection have an increased risk of Alzheimers Disease and Related Dementias due to enhanced survivorship with highly effective a nti retroviral therapies and/or increasing adiposity with aging. Objective: This work aimed to determine whether body mass index (BMI) and leptin were longitudinally associated over 10 years with neuropsychological performance (NP) among middle-aged women with HIV (WWH) vs without HIV. Methods: Women's Interagency HIV Study (WIHS) participants (301 WWH, 113 women without HIV from Brooklyn, NewYork City, and Chicago had baseline and 10-year BMI and fasting plasma leptin levels using commercial enzyme-linked immunosorbent assay (ng/mL); and demographically adjusted NP Tscores (attention/working memory, executive function [EF], processing speed, memory, learning, verbal fluency, motor function, global) at 10-year follow-up. Multivariate linear regression analyses, stratified by HIV serostatus, examined associations between BMI, leptin, and NR Results: Over 10 years, women (baseline age 39.8 [+ or -] 9.2 years, 73% Black, 73%WWH) transitionedfromaverageoverweight(29.1 [+ or -]7.9)toobese(30.5[+ or -] 7.9) BMI. Leptin increased 11.4 [+ or -] 26.4 ng/mL (P< .001). Higher baseline BMI and leptin predicted poorer 10-year EF among all women (BMI (3 = -6.97, 95% CI (-11.5 to -2.45) P=.003; leptin (3 = -1.90, 95% CI (-3.03 to -0.76), P = .001); higher baseline BMI predicted better memory performance (|3 = 6.35,95% CI (1.96-10.7), P = .005). Greater 10-year leptin increase predicted poorer EF (P = .004), speed (P= .03), and verbal (P= .02) and global (P= 0.005) performance among all women, and WWH. Greater 10-year BMI increase predicted slower processing speed (P= .043) among all women; and among WWH, poorer EF (P= .01) and global (P= .04) performance. Conclusion: In middle-aged WIHS participants, 10-year increases in BMI and leptin were associated with poorer performance across multiple NP domains among all women and WWH. Trajectories of adiposity measures over time may provide insight into the role of adipose tissue in brain health with aging. Key Words: cognition, leptin, HIV, women, overweight, obesity, body mass index