Impaired insulin sensitivity is associated with worsening cognition in HIV-infected patients.
Title | Impaired insulin sensitivity is associated with worsening cognition in HIV-infected patients. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Khuder, SS, Chen, S, Letendre, S, Marcotte, T, Grant, I, Franklin, D, Rubin, LH, Margolick, JB, Jacobson, LP, Sacktor, N, D'Souza, G, Stosor, V, Lake, JE, Rapocciolo, G, McArthur, JC, Dickens, AM, Haughey, NJ |
Journal | Neurology |
Volume | 92 |
Issue | 12 |
Pagination | e1344-e1353 |
Date Published | 2019 03 19 |
ISSN | 1526-632X |
Keywords | Adult, Anti-HIV Agents, C-Peptide, Case-Control Studies, Cognition, Cognitive Dysfunction, Cohort Studies, Female, HIV Infections, Humans, Hyperinsulinism, Insulin Resistance, Lipoproteins, Male, Middle Aged |
Abstract | OBJECTIVE: To determine the association of insulin sensitivity and metabolic status with declining cognition in HIV-infected individuals.METHODS: We conducted targeted clinical and metabolic measures in longitudinal plasma samples obtained from HIV-infected patients enrolled in the Central Nervous System HIV Anti-Retroviral Therapy Effects Research Study (CHARTER). Findings were validated with plasma samples from the Multicenter AIDS Cohort Study (MACS). Patients were grouped according to longitudinally and serially assessed cognitive performance as having stably normal or declining cognition.RESULTS: Patients with declining cognition exhibited baseline hyperinsulinemia and elevated plasma c-peptide levels with normal c-peptide/insulin ratios, suggesting that insulin production was increased, but insulin clearance was normal. The association of hyperinsulinemia with worsening cognition was further supported by low high-density lipoprotein (HDL), high low-density lipoprotein/HDL ratio, and elevated cholesterol/HDL ratio compared to patients with stably normal cognition.CONCLUSIONS: These findings suggest that hyperinsulinemia and impaired insulin sensitivity are associated with cognitive decline in antiretroviral therapy-treated HIV-infected patients. |
DOI | 10.1212/WNL.0000000000007125 |
Alternate Journal | Neurology |
PubMed ID | 30787163 |
PubMed Central ID | PMC6511093 |
Grant List | U01 AI035042 / AI / NIAID NIH HHS / United States P30 MH075673 / MH / NIMH NIH HHS / United States U01 HL146201 / HL / NHLBI NIH HHS / United States R01 MH110246 / MH / NIMH NIH HHS / United States P30 MH062512 / MH / NIMH NIH HHS / United States U01 AI035039 / AI / NIAID NIH HHS / United States P01 MH105280 / MH / NIMH NIH HHS / United States |