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High waist circumference related to neurocognitive impairment in HIV
McCutchan JA. Neurology. 2012;78:485-492.
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Centralized obesity was associated with a higher prevalence of neurocognitive impairment in patients with HIV, according to researchers from the University of California, San Diego.
The cross-sectional substudy of the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) cohort included 130 patients with HIV who provided fasting blood samples.
All patients completed 12 neuropsychological tests that assessed cognitive domains commonly affected by HIV. The tests were adjusted for age, education, gender and race/ethnicity. The researchers determined global ratings and global deficit scores.
Neurocognitive impairment, defined as a global impairment rating of 5 or more, was diagnosed in 40% of the patients. Compared to those without neurocognitive impairment, those with neurocognitive impairment were older, hand longer self-reported durations of HIV, had larger waist circumferences and were more likely to have been diagnosed with diabetes. Other variables, including current and nadir CD4 count, plasma and CSF viral loads and ART exposure, were similar between the groups.
In a multivariate analysis, central obesity, measured by the waist circumference also increased the risk of neurocognitive impairment. The researchers also looked at whether self-reported diabetes was associated with neurocognitive impairment in the entire CHARTER cohort, and found that it correlated only in people older than 55.
“When BMI was the only measure of obesity in a multivariate model, higher BMIs were associated with neurocognitive impairment,” the researchers wrote. “However, the best multivariate model for predicting neurocognitive impairment included both waist circumference and BMI. Greater waist circumference and lower BMI, as well as a diagnosis of AIDS or diabetes, were significant predictors of neurocognitive impairment.”
Disclosure: The researchers report no relevant financial disclosures.
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