Abstract
This study aimed to explore the relationship of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with cognition in women with (HIV+) and without HIV (HIV−) infection. One thousand six hundred ninety participants (1,196 HIV+, 494 HIV−) in the Women’s Interagency HIV Study (WIHS) with data available on anthropometric measures comprise the analytical sample. Cross-sectional analyses using linear regression models estimated the relationship between anthropometric variables and Trails A, Trails B, Stroop interference time, Stroop word recall, Stroop color naming and reading, and Symbol Digit Modalities Test (SDMT) with consideration for age, HIV infection status, Wide Range Achievement Test score, CD4 count, insulin resistance, drug use, and race/ethnicity. Among HIV+ women, BMI < 18.5 kg/m2 was associated with poorer cognitive performance evidenced by longer Trails A and Trails B and shorter SDMT completion times. An obese BMI (30 kg/m2 or higher) was related to better performance on Trails B and worse performance on the Stroop interference test. Among HIV− women, an obese BMI was related to worse performance on the Stroop color naming test. Few and inconsistent associations were observed between WC, WHR, and cognition. Among women at mid-life with chronic (at least 10 years) HIV infection, common anthropometric measures, primarily BMI, were differentially related to cognitive test performance by cognitive domain. Higher levels of BMI were associated with better cognitive function. In this era of antiretroviral therapies, restoration of health evidenced as higher BMI due to effective antiretroviral therapies, may improve cognitive function in middle-aged HIV-infected women.
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Acknowledgments
This study is supported in part by grants 1R01MH076537, 1R01MH079880, and IAID U01 318345. Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS) Collaborative Study Group with centers (Principal Investigators) at New York City/Bronx Consortium (Kathryn Anastos); Brooklyn, NY (Howard Minkoff, Deborah Gustafson); Washington DC, Metropolitan Consortium (Mary Young); The Connie Wofsy Study Consortium of Northern California (Ruth Greenblatt); Los Angeles County/Southern California Consortium (Alexandra Levine); Chicago Consortium (Mardge Cohen); and Data Coordinating Center (Stephen Gange). The WIHS is funded by the National Institute of Allergy and Infectious Diseases (UO1-AI-35004, UO1-AI-31834, UO1-AI-34994, UO1-AI-34989, UO1-AI-34993, and UO1-AI-42590) and by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (UO1-HD-32632). The study is co- funded by the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute on Deafness and Other Communication Disorders. Funding is also provided by the National Center for Research Resources (UCSF-CTSI grant number UL1 RR024131). Dr. Gustafson received support from NIH/NIAID ARRA Supplement No. 54492, Swedish Research Council Diarienummer: 523-2005-8460, and the SUNY Research Foundation.
The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
We thank the women participating in WIHS for their time, cooperation, and support.
Conflict of interest
All authors, Deborah R. Gustafson, MS, PhD, Michelle M. Mielke, PhD, Phyllis C. Tien, MD, Victor Valcour, MD, Mardge Cohen, MD, Kathryn Anastos, MD, Chenglong Liu, MD, PhD, Leigh Pearce, PhD, Elizabeth T. Golub, PhD, Howard Minkoff, MD, and Howard A. Crystal, MD, have nothing to declare.
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Gustafson, D.R., Mielke, M.M., Tien, P.C. et al. Anthropometric measures and cognition in middle-aged HIV-infected and uninfected women. The Women’s Interagency HIV Study. J. Neurovirol. 19, 574–585 (2013). https://doi.org/10.1007/s13365-013-0219-1
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DOI: https://doi.org/10.1007/s13365-013-0219-1