Body Mass Index and Leptin Are Related to Cognitive Performance Over 10 Years in Women With and Without HIV Infection

Macaluso, Francesca; Weber, Kathleen M.; Rubin, Leah H.; Dellinger, Elaine; Holman, Susan; Minkoff, Howard; Keating, Sheila M.; Merlin, Lisa R.; Gustafson, Deborah

doi:10.1210/clinem/dgab759

Cited by 5 publications

(12 citation statements)

References 52 publications

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“…The association of 1-year increase in plasma Aβ40 with memory performance was consistent among both WLWH and WLWOH, and the magnitude of the regression coefficient was largest for NP associations with Aβ42 followed by t-tau and p-tau 231 . In addition, WLWH performed more poorly on learning, memory, verbal fluency and global NP compared with WLWOH, as previously reported in the WIHS …”

Section: Discussionsupporting

confidence: 83%

“…For example, higher blood levels of NFL and GFAP have been observed in several neurological conditions and accompany peripheral and central neurological injury or events . Fourth, other blood-based biomarkers of inflammation (eg, chemokines, interleukins, and tissue inhibitor of metalloproteinases-1) and altered metabolism (eg, leptin, adiponectin, ghrelin, amylin, and gastric inhibitory peptide) have been associated with NP in WLWH in the WIHS at different times over the adult life course . We cannot consider their contribution here.…”

Section: Discussionmentioning

confidence: 98%

“…The NP battery included the Letter-Number Sequencing test, Trail Making Test Part B, Stroop Test (color word and word reading), Hopkins Verbal Learning Test-Revised (HVLT-R), Symbol Digit Modalities Test, Controlled Oral Word Association Test, Category Fluency Test (Animals), and Grooved Pegboard Test . Performance on these assessments was used to assess 7 NP domains: (1) attention and working memory (outcomes: total correct on the Letter-Number Sequencing control and experimental conditions), (2) executive function (outcomes: time to completion on the Trail Making Test Part B and Stroop color word test [interference] trial), (3) processing speed (outcomes: total correct on the Symbol Digit Modalities Test and time to completion on the Stroop word-reading trial), (4) memory (outcome: HVLT-R delayed recall score), (5) learning (outcome: total learning across HVLT-R trials), (6) verbal fluency (outcomes: total correct on Controlled Oral Word Association Test and Category Fluency Animals test); and (7) fine motor skills (outcomes: total time to completion for each hand on the Grooved Pegboard test) …”

Section: Methodsmentioning

confidence: 99%

“…Sociodemographic factors included age, education, Wide Range Achievement Test reading subtest (WRAT-3) score, race (Black or African American compared with White individuals and individuals of other races), and ethnicity (Hispanic and non-Hispanic). T-scores were calculated to create domain-specific and global NP scores . Global NP score was the calculated mean of the 7 NP domains.…”

Section: Methodsmentioning

confidence: 99%

“…Covariates were selected on the basis of previous WIHS analyses and included income, BMI, CES-D score, history of diabetes, use of hypertensive medication, alcohol, tobacco, marijuana, and other drug use (crack, cocaine, or heroin) . We also adjusted for eGFR because kidney function may influence some of these biomarker levels .…”

Section: Methodsmentioning

confidence: 99%

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Plasma Biomarkers of Alzheimer Disease in Women With and Without HIV

Li,

Yucel,

Clervius

et al. 2023

JAMA Netw Open

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ImportanceBlood-based biomarkers associated with increased risk of Alzheimer disease (AD) are understudied in people living with and without HIV, particularly women.ObjectiveTo determine whether baseline or 1-year changes in plasma amyloid-β40 (Aβ40), Aβ42, ratio of Aβ42 to Aβ40, total tau (t-tau), phosphorylated tau 231 (p-tau231), glial fibrillary acidic protein (GFAP), and/or neurofilament light chain (NFL) are associated with neuropsychological performance (NP) among women living with HIV (WLWH) and women living without HIV (WLWOH).Design, Setting, and ParticipantsThis longitudinal, prospective, cohort study with 1-year repeated clinical measures (NP only measured once) and biospecimen collection occurred between 2017 and 2019. Participants were women aged 40 years or older from 10 clinical research sites in cities across the US that were part of the Women’s Interagency HIV Study. Data analysis was conducted from April to December 2022.ExposureLaboratory-confirmed HIV status and AD biomarkers.Main Outcomes and MeasuresSociodemographically adjusted NP T-scores (attention and working memory, executive function, processing speed, memory, learning, verbal fluency, motor function, and global performance) were the primary outcomes. Baseline and 1-year fasting plasma Aβ40, Aβ42, t-tau, p-tau231, GFAP, and NFL levels were measured and analyzed using multivariable linear regression.ResultsThe study consisted of 307 participants (294 aged ≥50 years [96%]; 164 African American or Black women [53%]; 214 women with a high school education or higher [70%]; 238 women who were current or former smokers [78%]; and 236 women [77%] who were overweight or obese [body mass index &gt;25]) including 209 WLWH and 98 WLWOH. Compared with WLWOH at baseline, WLWH performed worse on learning (mean [SD] T-score 47.8 [11.3] vs 51.4 [10.5]), memory (mean [SD] T-score 48.3 [11.6] vs 52.4 [10.2]), verbal fluency (mean [SD] T-score 48.3 [9.8] vs 50.7 [8.5]), and global (mean [SD] T-score 49.2 [6.8] vs 51.1 [5.9]) NP assessments. Baseline median Aβ40, GFAP, and NFL levels were higher among WLWH vs WLWOH. There were no differences in 1-year biomarker change by HIV serostatus. Lower learning, memory, and motor NP were associated with 1-year Aβ40 increase; lower learning and motor with Aβ42 increase; lower motor with p-tau231 increase; and lower processing speed, verbal fluency and motor with NFL increase in the entire sample. Among WLWH, a 1-year increase in Aβ40 from baseline to follow-up was associated with worse learning, memory, and global NP; a 1-year increase in t-tau with worse executive function; and a 1-year increase in NFL with worse processing speed. Among WLWOH, a 1-year increase in Aβ40 and Aβ42 were associated with poorer memory performance and NFL was associated with poorer motor performance.Conclusions and RelevanceThese findings suggest that increases in certain plasma AD biomarkers are associated with NP in WLWH and WLWOH and may be associated with later onset of AD, and measuring these biomarkers could be a pivotal advancement in monitoring aging brain health and development of AD among women with and without HIV.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 98%