title: Insulin resistance and cognition among HIV-infected and HIV-uninfected adult women: the Women's Interagency HIV Study.
abstract: Cognitive impairment remains prevalent in the era of combination antiretroviral therapy (cART) and may be partially due to comorbidities. We postulated that insulin resistance (IR) is negatively associated with cognitive performance. We completed a cross-sectional analysis among 1547 (1201 HIV(+)) women enrolled in the Women's Interagency HIV Study (WIHS). We evaluated the association of IR with cognitive measures among all WIHS women with concurrent fasting bloods and cognitive testing [Trails A, Trails B, and Symbol Digit Modalities Test (SDMT)] using multiple linear regression models. A smaller subgroup also completed the Stroop test (n=1036). IR was estimated using the Homeostasis Model Assessment (HOMA). Higher HOMA was associated with poorer performance on the SDMT, Stroop Color-Naming (SCN) trial, and Stroop interference trial, but remained statistically significant only for the SCN in models adjusting for important factors [β=3.78 s (95% CI: 0.48-7.08), p=0.025, for highest vs. lowest quartile of HOMA]. HIV status did not appear to substantially impact the relationship of HOMA with SCN. There was a small but statistically significant association of HOMA and reduced neuropsychological performance on the SCN test in this cohort of women.
authors: Memory and Aging Center, Department of Neurology and Division of Geriatric Medicine, Department of Medicine, University of California at San Francisco, 350 Parnassus Avenue, San Francisco,CA 94143, USA. vvalcour@memory.ucsf.edu
authors: Victor
authors: V
authors: Valcour
authors: Pauline
authors: P
authors: Maki
authors: Peter
authors: P
authors: Bacchetti
authors: Kathryn
authors: K
authors: Anastos
authors: Howard
authors: H
authors: Crystal
authors: Mary
authors: M
authors: Young
authors: Wendy J
authors: WJ
authors: Mack
authors: Mardge
authors: M
authors: Cohen
authors: Elizabeth T
authors: ET
authors: Golub
authors: Phyllis C
authors: PC
authors: Tien
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000821:virology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance; D009483:Neuropsychological Tests; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D016387:Women's Health
chemical_list: D019380:Anti-HIV Agents