Journal of AIDS & Clinical Research

Obesity, Cytokines and Cognition across the Lifespan among People Living with HIV

Abstract

María José Míguez, Diego Bueno, Caroline Perez, Luis A Espinoza, Mayra E Vargas, Clery Quiros and Ronald Cohen

Background/objective: Neurocognitive Impairment (NCI) remains prevalent among people living with HIV (PLWH/AIDS), and may be exacerbated by body core changes. Waist circumference, a metabolic syndrome (MetSy) criterion, is not routinely measured, yet could be particularly useful when considering that both antiretroviral therapy (ART) and Hazardous alcohol use (HAU) have been associated with central fat accumulation. The purpose of this work was to examine the longitudinal associations between body mass index (BMI), waist circumference (WC), and cognitive performance in PLWH/AIDS, and to explore their modifications by age.

Methods: Using a prospective cohort study, we obtained participants’ anthropometrics, along with a comprehensive cognitive assessment over one year. Subjects were classified as overweight if BMI was 25-29.9 kg/m2, and obese if BMI was ≥ 30 kg/m2. Central obesity was defined as a waist >35 inches for females and >40 inches for males. Neurocognitive Impairment was defined using individual and global deficit corrected scores.

Results/conclusion: A sizable proportion of participants met the National Institutes of Health definition of overweight (BMI=25-29.9 kg/m2; 26%) and obese (BMI ≥ 30 kg/m2; 35%). Central obesity was present in more than half of the population (52%) and was higher in males than females (OR=5). Higher BMI and higher WC, both in young individuals and in the elderly, were related to worse cognitive performance. Cognitive performance across different tests was worst in obese individuals. Central obesity subtly impacts mood and motor skills. Analyses uncovered a likely mechanism for these cognitive deficits, as interleukin (IL)-9, 10, 17, 20, 23 and TNF were significantly associated with most cognitive variables. Age has a substantial impact on the relationship between cytokines and cognitive performance as most correlations became non-significant among the older individuals. The results indicate the importance of cytokines and obesity to neurocognitive status.