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Metabolic Alterations and Physical Function in Older HIV-Infected Adults.....Older HIV-infected persons have diminished physical performance compared to HIV-uninfected controls / Aging at CROI
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Reported by Jules Levin
CROI 2016 Feb 22-24 Boston
Mehri McKellar; James Bain; Olga Ilkayeva; Michael Muehlbauer; Thomas O'Connell; Robert Stevens; Miriam Morey; Carl Pieper; William Kraus; Kim Huffman
Duke Univ, Durham, NC, USA
HIV-infected older persons have accelerated rates of physical function decline compared to HIV-uninfected persons of similar age and gender. The biological mechanisms for this are not well-understood but may include disordered metabolism. To identify possible metabolic perturbations, we conducted metabolic profiling in a cohort of older HIV-infected patients on antiretroviral therapy (ART) who had completed physical performance measures.
Physical performance testing (8-foot walk, grip strength, 30-second chair stand, and 6-minute walk) was performed in 117 HIV-infected older persons (>50 years old) on ART with undetectable HIV-1 viral loads in the Duke HIV Clinic, in Durham, NC. Targeted metabolic profiling of acylcarnitines and amino acids was conducted using mass spectrometry on plasma collected at time of physical performance testing. Metabolites were then correlated with physical performance and a comorbidity index (1 low - 5 high) using Spearman's Rank Correlation Coefficient.
117 participants were enrolled (mean age 60.3 years; 70% male, 59% black, 38% white, non-Hispanic; mean BMI 28.6 kg/m2; mean length of time since diagnosis 15.3 years, mean current CD4 count 691 cells/mm3). Results from all 4 physical performance tests showed significantly impaired performance when compared to normal reference ranges for HIV-uninfected adults matched by age and gender.
Short-chain acylcarnitines, including odd chain length dicarboxyls representing incomplete oxidation products of amino acid metabolism, were negatively associated with 8-foot walk speed and positively associated with the co-morbidity index. C18 acylcarnitines were positively associated with several functional measures, including the 30-second chair stand, 6-minute walk and 8-foot walk speed. Long-chain dicarboxyl acylcarnitines were positively associated with the co-morbidity index. The amino acids serine and methionine were negatively associated with the co-morbidity index.
Older HIV-infected persons have diminished physical performance compared to HIV-uninfected controls. Individual metabolites appear to be associated with impaired physical performance and a higher comorbidity index, including the dicarboxyl short and long chain acylcarnitines which have been associated with excess mortality in other populations. Further study will be required to assess the significance of these associations.
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HIV & Aging: Psychosocial, mental health,
and behavioral issues/services/mental health
policy......
http://www.natap.org/2015/HIV/070915_03.htm
At this 2016 CROI, here were a few select aging-related studies reported: ....higher risk of stroke in HIV+ vs HIV-negatives....http://www.natap.org/2016/CROI/croi_84.htm
CROI: STROKE INCIDENCE HIGHEST IN WOMEN AND BLACK HIV-INFECTED PARTICIPANTS IN ALLRT COHORT - (02/26/16)
CROI: Factors Associated with Limitations in Daily Activity Among Older HIV+ Adults - (02/29/16)
CROI: Frailty is associated with NNRTI-based Initial ART and Modifiable Risks in ACTG 5322 - (02/29/16)
CROI: First Look at Big 75-and-Older HIV Group--Diagnosed at Age 62.....much higher rates of comorbidities among older HIV+ - 40% with 2 or more, 14% with 4 or more comorbidities - (03/03/16)
CROI: Aging with HIV: Emerging importance of chronic comorbidities in patients over 75 - (02/29/16)
from the CDC - CROI: Trends in Comorbid Conditions Mentioned with HIV Disease on Death Certificates, United States, 2000-2010 ...Comorbidities' Deaths Sharply Increasing/Leaders Ignore Problem - (02/29/16)
CROI: Depression and Social Isolation Mediate Effect of HIV Stigma on Women's ART Adherence - (02/26/16)
CROI: Increasing Hypertension and Diabetes Rx for HIV+ Women, But Poor Control - (02/25/16)
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