Abnormal Glucose Regulation Associated With Cognitive Dysfunction in HIV+ Men

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In this large, prospective study, the authors examined the relationship between glycemic status and cognitive performance in men living with and without HIV.
In this large, prospective study, the authors examined the relationship between glycemic status and cognitive performance in men living with and without HIV.

Abnormalities in glucose metabolism were associated with neuropsychological dysfunction in both people living with HIV and those without HIV, according to findings published in AIDS. A higher degree of impaired cognition may be correlated with poor glycemic control and a longer duration of type 2 diabetes mellitus (T2DM).

T2DM has been associated with varying degrees of cognitive dysfunction in the general population, with the duration of T2DM, glycemic control, and type of medication largely determining the degree of impairment. In this large prospective study, the authors examined the relationship between glycemic status and cognitive performance in men living with and without HIV.

Using data from the Multicenter AIDS Cohort Study, 1 of the largest ongoing cohorts of the natural and treated history of HIV among gay/bisexual men, the current analysis included 1149 HIV+ men and 900 HIV− men, who were followed for a mean of 13±4 years.

At baseline, HIV+ men were more likely to have glucose metabolism abnormalities vs HIV− men, but no statistically significant differences were observed among intravenous drug users, glucose levels, use of antidiabetic medications, and duration of T2DM, according to HIV serostatus.

HIV+ men had significantly more person-visits with impaired fasting glucose (52.1% vs 47.9%) and controlled DM vs HIV− men (58.2% vs 41.8%; P <.05).

Those with diabetes also had significantly poorer performance on psychomotor speed, executive function, and verbal learning (all P <.05) vs participants with normal glucose levels.

There was no difference in cognition by HIV serostatus.

"Glucose-mediated processes and duration of diabetic disease appear to be crucial, and therefore optimization of glycemic control appears to be an important goal for the maintenance of cognitive performance, along with control of other chronic vascular disease risk factors and lifestyle changes," wrote the authors.

Reference

Yang J, Jacobson LP, Becker JT, Levine A, Martin EM, Munro CA, Palella FJ, Lake JE, Sacktor NC, Brown TT. Impact of glycemic status on longitudinal cognitive performance in men with and without HIV infection [published online May 8, 2018]. AIDS. doi: 10.1097/QAD.0000000000001842

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