To investigate the differential associations of metabolic markers with cognitive performance in people with HIV (PWH) versus people without HIV (PWoH).
Approach:
Study Design: 200 participants were enrolled, stratified by HIV and diabetes status, completing neuropsychological testing and biomarker assessments.
Statistical Analysis: Multiple linear regression was used to examine associations between metabolic markers and cognitive performance, adjusting for covariates.
Key Findings:
Higher Diabetes Risk Index (DRI) levels were associated with worse cognitive performance (standardized β = -0.27, p = 0.009).
Higher Lipoprotein Insulin Resistance Index (LP-IR) was linked to worse cognitive performance in PWH but not in PWoH (interaction p = 0.007).
Betaine was associated with better cognitive performance in PWH (standardized β = 0.24, p = 0.02) and correlated with lower LP-IR (standardized β = -0.47, p < 0.01) and lower DRI (ps < 0.05).
Interpretation:
Insulin resistance may have a more significant impact on cognitive health in PWH compared to PWoH, indicating HIV-related metabolic vulnerabilities affecting brain health.
Limitations:
Observational study design limits causal inferences.
Findings may reflect metabolic, dietary, or lifestyle factors that require further investigation.
Conclusion:
Associations between betaine and improved metabolic profiles suggest potential areas for further research in preserving cognitive function in PWH.
