Neurology:中年肥胖可预测艾滋病患者认知能力下降

2019-06-16 xing.T MedSci原创

由此可见,较高的肥胖与较低的认知横断面和较大程度的认知能力下降相关,尤其是在HIV-男性中。超重和肥胖可能是神经系统预后、预防和干预途径的重要预测因素。

肥胖是一种常见的,可改变的心血管和脑血管危险因素。在艾滋病病毒感染者中,肥胖可能导致多系统失调,包括认知障碍。近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员评估了体重指数(BMI)和中心性肥胖(腰围[WC])与特定领域的认知功能以及HIV感染男性(MWH)与HIV未感染(HIV-)男性10年认知下降之间的相关性。

该研究共纳入了316名MWH和656名HIV-多中心艾滋病队列研究参与者,基线年龄≥40岁,每2年进行一次神经心理测试,同时进行BMI和WC测量。如果服用≥2种抗逆转录病毒药物,并且在>80%的就诊时HIV-1 RNA<400拷贝/mL,则纳入MWH。混合效应模型包括1996年至2015年的所有访问者,按HIV血清状况分层,并根据社会人口统计学指标、行为学指标和临床特征进行调整。在基线和随访时,分别有8%的MWH和15%的HIV-男性和41%的MWH和56%的HIV-男性≥60岁。 

横断面分析,较高的BMI与MWH和HIV男性的运动功能以及HIV男性的注意力/工作记忆呈负相关。WC与MWH和HIV男性的运动功能呈负相关。纵向关联表明,肥胖的BMI与MWH运动功能的急剧下降相关,而在HIV-男性中,肥胖与运动功能、学习和记忆的下降有关。WC或中心性肥胖症表现出相似的关联模式。

由此可见,较高的肥胖与较低的认知横断面和较大程度的认知能力下降相关,尤其是在HIV-男性中。超重和肥胖可能是神经系统预后、预防和干预途径的重要预测因素。 

原始出处:

Leah H. Rubin,et al.Midlife adiposity predicts cognitive decline in the prospective Multicenter AIDS Cohort Study.Neurology.2019.https://doi.org/10.1212/WNL.0000000000007779

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