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Type 2 diabetes is associated with lower cognitive performances in a cohort
of HIV-infected patients. ANRS CO3 Aquitaine Cohort, Bordeaux, France, 2007-2009
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Reported by Jules Levin
IAC 2012 Wash DC July 22-27
Carole Dufouil (1,2), Laura Richert (1,2), Mathias Bruyand(1,3),
Helene Amieva (1,2), Frederic-Antoine Dauchy (3),
Carine Greib (4), Jean-Francois Dartigues (1,2,3),
Didier Neau (3), Francois Dabis (1,2,3), Philippe Morlat (1,2,3), Fabrice Bonnet (1,2,3), Genevieve Chene (1,2,3) and the ANRS CO3 Aquitaine Study Group
(1) INSERM, Bordeaux School of Public Health (ISPED), Centre INSERM U897 & CIC-EC7, F-33000 Bordeaux, France
(2) Univ. Bordeaux, ISPED, Centre INSERM U897, F-33000 Bordeaux, France
(3) CHU de Bordeaux, F-33000 Bordeaux, France
(4) CHU de Bordeaux, F-33000 Pessac, France
400 HIV+ individuals in ANRS Aquitaine Cohort in France; average age 47; med CD4 nadir 260, current 515, 85% <500 c/ml; glycemic status 8% impaired, 9.5% diabetes; 20% hypertension, 44% hypercholeterol.
21% had ANI- asymptomatic neurocognitive disorders
32% had mild neurocognitive disorder (MND)
6.7% had HIV-associated dementia (HAD)
IN TABLE BELOW YOU SEE:
normal glycemic patients: 4.2% to 7.3% had ANI/MND
pre-diabetes: 9.5% to 11.9% had ANI/MND
diabetes: 11.8% to 11.1% had ANI/MND
PROGRAM ABSTRACT
Type 2 diabetes is associated with lower cognitive performances in a cohort of HIV-positive patients. ANRS CO3 Aquitaine Cohort, Bordeaux, France, 2007-2009
P
resented by Carole Dufouil (France).
C. Dufouil1, L. Richert1, M. Bruyand1, H. Amieva1, F.-A. Dauchy2, J.-F. Dartigues1, D. Neau2, F. Dabis3, P. Morlat2, F. Bonnet2, G. Chene1, ANRS CO3 Aquitaine Study Group
1INSERM Center 897, CIC-EC7, Bordeaux, France, 2Bordeaux Hospital, Bordeaux, France, 3INSERM Center 897, Bordeaux, France
Background: HIV infected patients receiving combination antiretroviral therapy are at higher risk of cardiovascular morbidity and have accelerated aging notably of cognitive functions. The link between cardiovascular risk factors and cognition has rarely been investigated in HIV-infected cohorts. In a large hospital-based cohort, we explored whether cardiovascular risk factors are associated with cognitive performances.
Methods: The ANRS-CO3 Aquitaine Cohort recruits patients through a hospital-based information system on HIV-1 infection in the Bordeaux University Hospital in the Aquitaine region, South Western France. Between 2007 and 2009, 403 patients participated in a sub-study and had a thorough assessment of several cognitive domains. Cognitive performances were analyzed using both the raw test scores and the presence of neurocognitive impairment (NCI), based on the most recent definition of HIV-associated neurocognitive disorders.
Selected cardiovascular risk factors were type 2 diabetes, hypertension, hypercholesterolemia, smoking status and BMI.
Covariance analyses were computed to investigate the association between cardiovascular risk factors and raw cognitive test scores, adjusting for potential confounders. Logistic regression with the same covariates was used to analyse NCI as dependent variable.
Results: Mean age was 47.3 years and 79% were male. The prevalence of cardiovascular risk factors ranged from 9.7% for diabetes to 49.6% for current smoking, and 37.7% of participants had NCI.
Lower performances in all cognitive tests were related to older age and lower education. Among cardiovascular risk factors, diabetes was significantly associated with lower performances in all cognitive tests after adjusting for potential confounders. By contrast, no such consistent associations were noted for any other cardiovascular risk factors. Diabetes prevalence did not significantly differ by NCI status(p=0.44).
Conclusions: In this hospital-based cohort, diabetes, but not the other cardiovascular risk factors, is associated with lower performances in all assessed cognitive domains. The mechanisms underlying our findings remain to be clarified but could involve inflammation and microcirculation.
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