Additive effect of metabolic syndrome on brain atrophy in people living with HIV – magnetic resonance volumetry study

Abstract

With people living with HIV (PLWH) reaching senium, the importance of aging-related comorbidities such as metabolic syndrome (MS) becomes increasingly important. The aim of this study was to determine the additive effect of MS on brain atrophy in PLWH. This prospective study included 43 PLWH, average age 43.02 ± 10.93 years and 24 healthy controls, average age 36.87 ± 8.89 years. PLWH were divided into two subgroups: without MS and with MS, according to NCEP-ATP-III criteria. All patients underwent brain magnetic resonance (MR)imaging on 3T clinical scanner with MR volumetry, used for defining volumes of cerebrospinal fluid (CSF) spaces and white and grey matter structures, including basal ganglia. ANOVA was used to determine differences in brain volumes between subject subgroups. Binary classification was performed to determine sensitivity and specificity of volumetry findings and cut-off values. Statistical significance was set at p < 0.05. PLWH presented with significantly lower volumes of gray matter, putamen, thalamus, globus pallidus and nc. accumbens compared to healthy controls; cut-off values were: for gray matter 738.130 cm3, putamen 8.535cm3, thalamus 11.895 cm3, globus pallidus 2.252 cm3 nc. accumbens 0.715 cm3. Volumes of CSF and lateral ventricles were higher in PLWH with MS compared to those without MS- with specificity of 0.310 and sensitivity of 0.714 it can be assumed that PLWH with CSF volume above 212.83cm3 will also have MS. There seems to be an important connection between MS and brain volume reduction in PLWH with MS, which may add to accurate identification of persons at risk of developing HIV-associated cognitive impairment.