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Download fileInsulin Resistance and Cognition Among HIV-Infected and HIV-Uninfected Adult Women: The Women’s Interagency HIV Study
journal contribution
posted on 01.11.2013, 00:00 authored by Victor Valcour, Pauline Maki, Peter Bacchetti, Kathryn Anastos, Howard Crystal, Mary Young, Wendy J. Mack, Mardge Cohen, Elizabeth T. Golub, Phyllis C. TienCognitive impairment remains prevalent in the era of combination antiretroviral therapy (cART) and may be
partially due to comorbidities. We postulated that insulin resistance (IR) is negatively associated with cognitive
performance. We completed a cross-sectional analysis among 1547 (1201 HIV+ ) women enrolled in the Women’s
Interagency HIV Study (WIHS). We evaluated the association of IR with cognitive measures among all WIHS
women with concurrent fasting bloods and cognitive testing [Trails A, Trails B, and Symbol Digit Modalities Test
(SDMT)] using multiple linear regression models. A smaller subgroup also completed the Stroop test (n = 1036).
IR was estimated using the Homeostasis Model Assessment (HOMA). Higher HOMA was associated with
poorer performance on the SDMT, Stroop Color-Naming (SCN) trial, and Stroop interference trial, but remained
statistically significant only for the SCN in models adjusting for important factors [b = 3.78 s (95% CI: 0.48–7.08),
p = 0.025, for highest vs. lowest quartile of HOMA]. HIV status did not appear to substantially impact the
relationship of HOMA with SCN. There was a small but statistically significant association of HOMA and
reduced neuropsychological performance on the SCN test in this cohort of women.