Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV
Background and objectiveObservations of overweight and obesity in association with neuropsychological performance (NP) vary over the adult life course depending on baseline levels, biological sex, age, race, temporality of measurements, and other factors. Therefore, similar published analyses across...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1108313/full |
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| author | Elizabeth Vásquez Mark H. Kuniholm Allison A. Appleton Leah H. Rubin Leah H. Rubin Leah H. Rubin Ada A. Adimora Ada A. Adimora Margaret A. Fischl Ervin Fox Wendy J. Mack Susan Holman Caitlin Anne Moran Caitlin Anne Moran Howard Minkoff Michael W. Plankey Anjali Sharma Phyllis C. Tien Phyllis C. Tien Kathleen M. Weber Deborah R. Gustafson |
| author_facet | Elizabeth Vásquez Mark H. Kuniholm Allison A. Appleton Leah H. Rubin Leah H. Rubin Leah H. Rubin Ada A. Adimora Ada A. Adimora Margaret A. Fischl Ervin Fox Wendy J. Mack Susan Holman Caitlin Anne Moran Caitlin Anne Moran Howard Minkoff Michael W. Plankey Anjali Sharma Phyllis C. Tien Phyllis C. Tien Kathleen M. Weber Deborah R. Gustafson |
| author_sort | Elizabeth Vásquez |
| collection | DOAJ |
| description | Background and objectiveObservations of overweight and obesity in association with neuropsychological performance (NP) vary over the adult life course depending on baseline levels, biological sex, age, race, temporality of measurements, and other factors. Therefore, similar published analyses across cohorts are inconsistent. In our sample of women living with HIV (WLWH) and women without HIV (WWOH), we conducted comparable analyses as those published in men with and without HIV. We examined cross-sectional and longitudinal associations between body mass index (BMI) and waist circumference (WC) and NP.MethodsFour hundred thirty two 432 virologically-suppressed WLWH and 367 WWOH, ≥40 years in the Women’s Interagency HIV Study (WIHS) with anthropometry and NP assessments every two years from 2009-2019 were included in the study. Demographically-adjusted T-scores were calculated for six NP domains: learning, memory, executive function, processing speed, attention and working memory, and motor function. Multivariable linear regression models stratified by HIV status were used to examine cross-sectional associations of BMI and WC by NP domain; repeated measures analyses assessed baseline BMI and WC in association with longitudinal change in NP. Covariates included sociodemographic, behavioral, and HIV-related characteristics.ResultsAt baseline among all women, the median age was 45 years, 65% were Non-Latinx Black women, and 45% were obese women. Obese WLWH (BMI≥30.0 kg/m2) had poorer executive function (β=-2.27, 95%CI [-4.46, -0.07]) versus WLWH with healthy BMI (18.5–24.9 kg/m2). Longitudinally over ~8 years, obese versus overweight WWOH improved on memory (β=2.19, 95%CI [0.13, 4.26]), however overweight versus healthy WWOH experienced declining memory (β= -2.67, 95%CI [-5.40, -0.07]). Increasing WC was associated with declining executive, processing speed, and motor function (p’s<0.05); an at-risk WC was associated with improved memory (β=1.81, 95%CI [0.19, 3.44]) among WWOH. Among WLWH, increasing BMI was associated with improved learning (β=0.07, 95%CI [0.00, 0.15].ConclusionOur cross-sectional and longitudinal analyses evaluating the associations of BMI and WC and NP were mixed compared to previous reports. This illustrates the importance of sociodemographic characteristics, baseline levels of exposures and outcomes, HIV status, temporality of measurements, and other factors when evaluating aging HIV epidemiology study results. |
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| publishDate | 2023-07-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-ec899a16d0b948688e087ced7c9956a12023-07-07T14:07:00ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-07-011410.3389/fendo.2023.11083131108313Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIVElizabeth Vásquez0Mark H. Kuniholm1Allison A. Appleton2Leah H. Rubin3Leah H. Rubin4Leah H. Rubin5Ada A. Adimora6Ada A. Adimora7Margaret A. Fischl8Ervin Fox9Wendy J. Mack10Susan Holman11Caitlin Anne Moran12Caitlin Anne Moran13Howard Minkoff14Michael W. Plankey15Anjali Sharma16Phyllis C. Tien17Phyllis C. Tien18Kathleen M. Weber19Deborah R. Gustafson20Department of Epidemiology and Biostatistics, University at Albany School of Public Health State University of New York, Rensselaer, NY, United StatesDepartment of Epidemiology and Biostatistics, University at Albany School of Public Health State University of New York, Rensselaer, NY, United StatesDepartment of Epidemiology and Biostatistics, University at Albany School of Public Health State University of New York, Rensselaer, NY, United StatesDepartment of Neurology, Johns Hopkins University, Baltimore, MD, United StatesDepartment of Psychology, Johns Hopkins University, Baltimore, MD, United StatesDepartment Epidemiology, Johns Hopkins University, Baltimore, MD, United StatesDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDepartment of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL, United StatesDepartment of Medicine, University of Mississippi Medical Center, Jackson, MS, United StatesPopulation and Public Health Sciences, University of Southern California, Los Angeles, CA, United States0Department of Medicine/STAR Program, State University of New York Health Sciences University, Brooklyn, NY, United States1Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States2Grady Healthcare System, Infectious Diseases Program, Atlanta, United States3Department of Neurology, State of New York Downstate Health Sciences University, Brooklyn, NY, United States4Department of Medicine, Georgetown University, Washington, DC, United States5Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States6Department of Medicine, University of California, San Francisco, CA, United States7Department of Veterans Affairs, San Francisco, CA, United States8Cook County Health/Hektoen Institute of Medicine, Chicago, IL, United States3Department of Neurology, State of New York Downstate Health Sciences University, Brooklyn, NY, United StatesBackground and objectiveObservations of overweight and obesity in association with neuropsychological performance (NP) vary over the adult life course depending on baseline levels, biological sex, age, race, temporality of measurements, and other factors. Therefore, similar published analyses across cohorts are inconsistent. In our sample of women living with HIV (WLWH) and women without HIV (WWOH), we conducted comparable analyses as those published in men with and without HIV. We examined cross-sectional and longitudinal associations between body mass index (BMI) and waist circumference (WC) and NP.MethodsFour hundred thirty two 432 virologically-suppressed WLWH and 367 WWOH, ≥40 years in the Women’s Interagency HIV Study (WIHS) with anthropometry and NP assessments every two years from 2009-2019 were included in the study. Demographically-adjusted T-scores were calculated for six NP domains: learning, memory, executive function, processing speed, attention and working memory, and motor function. Multivariable linear regression models stratified by HIV status were used to examine cross-sectional associations of BMI and WC by NP domain; repeated measures analyses assessed baseline BMI and WC in association with longitudinal change in NP. Covariates included sociodemographic, behavioral, and HIV-related characteristics.ResultsAt baseline among all women, the median age was 45 years, 65% were Non-Latinx Black women, and 45% were obese women. Obese WLWH (BMI≥30.0 kg/m2) had poorer executive function (β=-2.27, 95%CI [-4.46, -0.07]) versus WLWH with healthy BMI (18.5–24.9 kg/m2). Longitudinally over ~8 years, obese versus overweight WWOH improved on memory (β=2.19, 95%CI [0.13, 4.26]), however overweight versus healthy WWOH experienced declining memory (β= -2.67, 95%CI [-5.40, -0.07]). Increasing WC was associated with declining executive, processing speed, and motor function (p’s<0.05); an at-risk WC was associated with improved memory (β=1.81, 95%CI [0.19, 3.44]) among WWOH. Among WLWH, increasing BMI was associated with improved learning (β=0.07, 95%CI [0.00, 0.15].ConclusionOur cross-sectional and longitudinal analyses evaluating the associations of BMI and WC and NP were mixed compared to previous reports. This illustrates the importance of sociodemographic characteristics, baseline levels of exposures and outcomes, HIV status, temporality of measurements, and other factors when evaluating aging HIV epidemiology study results.https://www.frontiersin.org/articles/10.3389/fendo.2023.1108313/fullbody mass indexneuropsychological performanceHIVagingwaist circumferenceobesity |
| spellingShingle | Elizabeth Vásquez Mark H. Kuniholm Allison A. Appleton Leah H. Rubin Leah H. Rubin Leah H. Rubin Ada A. Adimora Ada A. Adimora Margaret A. Fischl Ervin Fox Wendy J. Mack Susan Holman Caitlin Anne Moran Caitlin Anne Moran Howard Minkoff Michael W. Plankey Anjali Sharma Phyllis C. Tien Phyllis C. Tien Kathleen M. Weber Deborah R. Gustafson Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV Frontiers in Endocrinology body mass index neuropsychological performance HIV aging waist circumference obesity |
| title | Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV |
| title_full | Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV |
| title_fullStr | Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV |
| title_full_unstemmed | Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV |
| title_short | Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV |
| title_sort | midlife body mass index central adiposity and neuropsychological performance over 10 years in women living with and without hiv |
| topic | body mass index neuropsychological performance HIV aging waist circumference obesity |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1108313/full |
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