Diabetes, insulin resistance, and dementia among HIV-1-infected patients

Victor G. Valcour, Cecilia M. Shikuma, Bruce T. Shiramizu, Andrew E. Williams, Michael R. Watters, Pamela W. Poff, John S. Grove, Ola A. Selnes, Ned Sacktor

Research output: Contribution to journalArticle

Abstract

Objectives: Metabolic complications have been associated with HIV-1 infection and with long-term use of antiretroviral (ARV) medications. In some studies, such complications have been linked to cardiovascular events, yet limited data exist concerning metabolic complications and dementia. The objective of this study was to examine the relationship between HIV-associated dementia (HAD) and diabetes among patients with HIV-1 infection. Design: Cross-sectional analysis of entry data for a longitudinal cohort study. Methods: A total of 203 participants who were enrolled in the Hawaii Aging with HIV Cohort between October 2001 and November 2003 served as the study population. Research case definitions of HAD were determined in consensus conferences by a panel that included neurologists, neuropsychologists, and a geriatrician. Diabetes was determined by self-report or a fasting glucose level > 125 mg/dL. Results: Participants' ages ranged between 20-76 years at enrollment with approximately one-half aged ≥50 years. After adjustment for important covariates including age, education, ethnicity, CD4 lymphocyte count, duration of HIV infection, and protease inhibitor-based ARV therapy, we found a statistically significant association of diabetes with HAD (odds ratio 5.43, 1.66-17.70). A significant association remained after adjustment for other vascular risk factors. Among participants without diabetes, fasting glucose levels were higher with increasing impairment category. Conclusions: Within the Hawaii Aging with HIV Cohort, a longitudinal study enriched with older HIV-1-infected individuals, diabetes is associated with prevalent dementia. This finding is not fully explained by age or coexisting vascular risk factors. Evaluation of underlying mechanisms is warranted.

Original languageEnglish (US)
Pages (from-to)31-36
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2005

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AIDS Dementia Complex
HIV Infections
Dementia
Insulin Resistance
HIV-1
Longitudinal Studies
Fasting
HIV
HIV Protease Inhibitors
Glucose
CD4 Lymphocyte Count
Self Report
Consensus
Cohort Studies
Cross-Sectional Studies
Odds Ratio
Education
Research
Population
vascular factor

Keywords

  • Dementia
  • Diabetes mellitus
  • HIV-1
  • Insulin resistance

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Diabetes, insulin resistance, and dementia among HIV-1-infected patients. / Valcour, Victor G.; Shikuma, Cecilia M.; Shiramizu, Bruce T.; Williams, Andrew E.; Watters, Michael R.; Poff, Pamela W.; Grove, John S.; Selnes, Ola A.; Sacktor, Ned.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 38, No. 1, 01.01.2005, p. 31-36.

Research output: Contribution to journalArticle

Valcour, VG, Shikuma, CM, Shiramizu, BT, Williams, AE, Watters, MR, Poff, PW, Grove, JS, Selnes, OA & Sacktor, N 2005, 'Diabetes, insulin resistance, and dementia among HIV-1-infected patients', Journal of Acquired Immune Deficiency Syndromes, vol. 38, no. 1, pp. 31-36. https://doi.org/10.1097/00126334-200501010-00006
Valcour, Victor G. ; Shikuma, Cecilia M. ; Shiramizu, Bruce T. ; Williams, Andrew E. ; Watters, Michael R. ; Poff, Pamela W. ; Grove, John S. ; Selnes, Ola A. ; Sacktor, Ned. / Diabetes, insulin resistance, and dementia among HIV-1-infected patients. In: Journal of Acquired Immune Deficiency Syndromes. 2005 ; Vol. 38, No. 1. pp. 31-36.
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AU - Poff, Pamela W.

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AU - Selnes, Ola A.

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