title: Brain morphometric correlates of metabolic variables in HIV: the CHARTER study.
abstract: Obesity and other metabolic variables are associated with abnormal brain structural volumes and cognitive dysfunction in HIV-uninfected populations. Since individuals with HIV infection on combined antiretroviral therapy (CART) often have systemic metabolic abnormalities and changes in brain morphology and function, we examined associations among brain volumes and metabolic factors in the multisite CNS HIV AntiRetroviral Therapy Effects Research (CHARTER) cohort, cross-sectional study of 222 HIV-infected individuals. Metabolic variables included body mass index (BMI), total blood cholesterol (C), low- and high-density lipoprotein C (LDL-C and HDL-C), blood pressure, random blood glucose, and diabetes. MRI measured volumes of cerebral white matter, abnormal white matter, cortical and subcortical gray matter, and ventricular and sulcal CSF. Multiple linear regression models allowed us to examine metabolic variables separately and in combination to predict each regional volume. Greater BMI was associated with smaller cortical gray and larger white matter volumes. Higher total cholesterol (C) levels were associated with smaller cortex volumes; higher LDL-C was associated with larger cerebral white matter volumes, while higher HDL-C levels were associated with larger sulci. Higher blood glucose levels and diabetes were associated with more abnormal white matter. Multiple atherogenic metabolic factors contribute to regional brain volumes in HIV-infected, CART-treated patients, reflecting associations similar to those found in HIV-uninfected individuals. These risk factors may accelerate cerebral atherosclerosis and consequent brain alterations and cognitive dysfunction.
authors.affiliation: Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive #0949, La Jolla, CA, 92093-0949, USA, sarchibald@ucsd.edu.
authors.forename: S L
authors.initials: SL
authors.lastname: Archibald
authors.forename: J A
authors.initials: JA
authors.lastname: McCutchan
authors.forename: C
authors.initials: C
authors.lastname: Sanders
authors.forename: T
authors.initials: T
authors.lastname: Wolfson
authors.forename: T L
authors.initials: TL
authors.lastname: Jernigan
authors.forename: R J
authors.initials: RJ
authors.lastname: Ellis
authors.forename: B M
authors.initials: BM
authors.lastname: Ances
authors.forename: A C
authors.initials: AC
authors.lastname: Collier
authors.forename: J C
authors.initials: JC
authors.lastname: McArthur
authors.forename: S
authors.initials: S
authors.lastname: Morgello
authors.forename: D M
authors.initials: DM
authors.lastname: Simpson
authors.forename: C
authors.initials: C
authors.lastname: Marra
authors.forename: B B
authors.initials: BB
authors.lastname: Gelman
authors.forename: D B
authors.initials: DB
authors.lastname: Clifford
authors.forename: I
authors.initials: I
authors.lastname: Grant
authors.forename: C
authors.initials: C
authors.lastname: Fennema-Notestine
mesh_terms: D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002540:Cerebral Cortex / Q000378:metabolism / Q000473:pathology*; D054022:Cerebrum / Q000378:metabolism / Q000473:pathology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D066128:Gray Matter / Q000378:metabolism / Q000473:pathology; D006678:HIV / Q000187:drug effects / Q000502:physiology; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D066127:White Matter / Q000378:metabolism / Q000473:pathology
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL