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Lipid Profiles and APOE4 Allele Impact Midlife Cognitive Decline in HIV-Infected Men on Antiretroviral Therapy

View Article: PubMed Central - PubMed

ABSTRACT

Elevated cholesterol and APOE ε4 genotype were independent risk factors for cognitive decline in antiretroviral therapy–adherent human immunodeficiency virus (HIV)-infected men aged 50–65 years, whereas higher high-density lipoprotein attenuated cognitive decline. Treatment of dyslipidemia may reduce midlife cognitive decline among HIV-infected individuals.

No MeSH data available.


Related in: MedlinePlus

Higher total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides are associated with faster rates of cognitive decline, whereas high-density lipoprotein cholesterol (HDL-C) levels attenuate decline in antiretroviral therapy–treated human immunodeficiency virus–infected (HIV+) men. A, Estimated slopes in neurocognitive scores according to total cholesterol, LDL-C, HDL-C, and log10 triglyceride levels stratified by HIV infection, and categorized by National Cholesterol Education Program guidelines are shown. The slopes are estimated for a man with study entry age of 50, and cohort mean IQ score 108, baseline Center for Epidemiological Studies Depression Scale score 9, and CD4 count held at 800 cells/mL. The x-axis is time in study (years) centered at zero for the first visit after age 50, and y-axis is the change in cognitive performance from the baseline score. There is an accelerated rate of age-related decline in the cognitive score as total cholesterol and triglycerides levels increase in human immunodeficiency virus–uninfected (HIV–) and HIV+ men, an effect not observed for LDL-C or HDL-C levels. Higher total cholesterol (P = .003), LDL-C (P = .002), and triglyceride (P = .04) levels in HIV+ men are associated with a steeper slope of cognitive decline during the study, whereas higher HDL-C levels attenuated the rate of decline (P = .02). B, Estimated slopes for cognitive scores according to statin use by total cholesterol levels. The association between elevated total cholesterol and faster rate of decline was attenuated in HIV+ men on a statin medication (P = .02).
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CIW495F2: Higher total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides are associated with faster rates of cognitive decline, whereas high-density lipoprotein cholesterol (HDL-C) levels attenuate decline in antiretroviral therapy–treated human immunodeficiency virus–infected (HIV+) men. A, Estimated slopes in neurocognitive scores according to total cholesterol, LDL-C, HDL-C, and log10 triglyceride levels stratified by HIV infection, and categorized by National Cholesterol Education Program guidelines are shown. The slopes are estimated for a man with study entry age of 50, and cohort mean IQ score 108, baseline Center for Epidemiological Studies Depression Scale score 9, and CD4 count held at 800 cells/mL. The x-axis is time in study (years) centered at zero for the first visit after age 50, and y-axis is the change in cognitive performance from the baseline score. There is an accelerated rate of age-related decline in the cognitive score as total cholesterol and triglycerides levels increase in human immunodeficiency virus–uninfected (HIV–) and HIV+ men, an effect not observed for LDL-C or HDL-C levels. Higher total cholesterol (P = .003), LDL-C (P = .002), and triglyceride (P = .04) levels in HIV+ men are associated with a steeper slope of cognitive decline during the study, whereas higher HDL-C levels attenuated the rate of decline (P = .02). B, Estimated slopes for cognitive scores according to statin use by total cholesterol levels. The association between elevated total cholesterol and faster rate of decline was attenuated in HIV+ men on a statin medication (P = .02).

Mentions: Time-related terms reflecting the association between total cholesterol levels and cognitive decline between ages 50–65 years are summarized in Table 2. While the estimated rate of cognitive decline accelerated with increasing cholesterol levels in both groups, HIV+ men had a faster rate of decline compared with HIV– controls (estimate = −0.0034, P = .003; Figure 2). Figure 2A depicts the estimated annual rate of decline for a 50-year-old man with and without HIV infection, illustrating 2 main findings: (1) On average, HIV+ men with higher cholesterol levels have faster rates of cognitive decline than HIV+ men with lower levels; and (2) the rate of cognitive decline in HIV+ men aged 50–65 years is differentially modified by cholesterol compared with HIV– men of the same age, IQ, baseline CES-D score, smoking status, and CD4 count. Higher cholesterol levels in HIV+ men were marginally associated with better cognitive scores at the intercept (total cholesterol * HIV+: estimate 0.01058; P = .05), suggesting that cognitive decline associated with elevated cholesterol most likely occurred after age 50. Older age and baseline CES-D scores correlated with lower cognitive scores; IQ was associated with higher scores (Supplementary Table 2).Table 2.


Lipid Profiles and APOE4 Allele Impact Midlife Cognitive Decline in HIV-Infected Men on Antiretroviral Therapy
Higher total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides are associated with faster rates of cognitive decline, whereas high-density lipoprotein cholesterol (HDL-C) levels attenuate decline in antiretroviral therapy–treated human immunodeficiency virus–infected (HIV+) men. A, Estimated slopes in neurocognitive scores according to total cholesterol, LDL-C, HDL-C, and log10 triglyceride levels stratified by HIV infection, and categorized by National Cholesterol Education Program guidelines are shown. The slopes are estimated for a man with study entry age of 50, and cohort mean IQ score 108, baseline Center for Epidemiological Studies Depression Scale score 9, and CD4 count held at 800 cells/mL. The x-axis is time in study (years) centered at zero for the first visit after age 50, and y-axis is the change in cognitive performance from the baseline score. There is an accelerated rate of age-related decline in the cognitive score as total cholesterol and triglycerides levels increase in human immunodeficiency virus–uninfected (HIV–) and HIV+ men, an effect not observed for LDL-C or HDL-C levels. Higher total cholesterol (P = .003), LDL-C (P = .002), and triglyceride (P = .04) levels in HIV+ men are associated with a steeper slope of cognitive decline during the study, whereas higher HDL-C levels attenuated the rate of decline (P = .02). B, Estimated slopes for cognitive scores according to statin use by total cholesterol levels. The association between elevated total cholesterol and faster rate of decline was attenuated in HIV+ men on a statin medication (P = .02).
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CIW495F2: Higher total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides are associated with faster rates of cognitive decline, whereas high-density lipoprotein cholesterol (HDL-C) levels attenuate decline in antiretroviral therapy–treated human immunodeficiency virus–infected (HIV+) men. A, Estimated slopes in neurocognitive scores according to total cholesterol, LDL-C, HDL-C, and log10 triglyceride levels stratified by HIV infection, and categorized by National Cholesterol Education Program guidelines are shown. The slopes are estimated for a man with study entry age of 50, and cohort mean IQ score 108, baseline Center for Epidemiological Studies Depression Scale score 9, and CD4 count held at 800 cells/mL. The x-axis is time in study (years) centered at zero for the first visit after age 50, and y-axis is the change in cognitive performance from the baseline score. There is an accelerated rate of age-related decline in the cognitive score as total cholesterol and triglycerides levels increase in human immunodeficiency virus–uninfected (HIV–) and HIV+ men, an effect not observed for LDL-C or HDL-C levels. Higher total cholesterol (P = .003), LDL-C (P = .002), and triglyceride (P = .04) levels in HIV+ men are associated with a steeper slope of cognitive decline during the study, whereas higher HDL-C levels attenuated the rate of decline (P = .02). B, Estimated slopes for cognitive scores according to statin use by total cholesterol levels. The association between elevated total cholesterol and faster rate of decline was attenuated in HIV+ men on a statin medication (P = .02).
Mentions: Time-related terms reflecting the association between total cholesterol levels and cognitive decline between ages 50–65 years are summarized in Table 2. While the estimated rate of cognitive decline accelerated with increasing cholesterol levels in both groups, HIV+ men had a faster rate of decline compared with HIV– controls (estimate = −0.0034, P = .003; Figure 2). Figure 2A depicts the estimated annual rate of decline for a 50-year-old man with and without HIV infection, illustrating 2 main findings: (1) On average, HIV+ men with higher cholesterol levels have faster rates of cognitive decline than HIV+ men with lower levels; and (2) the rate of cognitive decline in HIV+ men aged 50–65 years is differentially modified by cholesterol compared with HIV– men of the same age, IQ, baseline CES-D score, smoking status, and CD4 count. Higher cholesterol levels in HIV+ men were marginally associated with better cognitive scores at the intercept (total cholesterol * HIV+: estimate 0.01058; P = .05), suggesting that cognitive decline associated with elevated cholesterol most likely occurred after age 50. Older age and baseline CES-D scores correlated with lower cognitive scores; IQ was associated with higher scores (Supplementary Table 2).Table 2.

View Article: PubMed Central - PubMed

ABSTRACT

Elevated cholesterol and APOE ε4 genotype were independent risk factors for cognitive decline in antiretroviral therapy–adherent human immunodeficiency virus (HIV)-infected men aged 50–65 years, whereas higher high-density lipoprotein attenuated cognitive decline. Treatment of dyslipidemia may reduce midlife cognitive decline among HIV-infected individuals.

No MeSH data available.


Related in: MedlinePlus