Interactions between betaine, insulin resistance, and cognitive impairment in people with and without HIV

15 Jul 20264 min read0 viewsJournal Feed

GIST (Key Takeaways)

Background. Metabolic dysfunction and neurocognitive decline share inflammatory pathways that may be amplified in people with HIV (PWH). Prior studies suggest insulin resistance correlates with cognitive decline, while gut-related metabolites, such as betaine, may be protective through metabolic regulation and anti-inflammatory effects. We investigated whether metabolic markers differentially associate with cognitive performance in PWH versus people without HIV (PWoH).Methods.
We enrolled 200 participants, equally stratified by HIV and diabetes mellitus status, into four groups of 50. All completed neuropsychological testing yielded demographically corrected global T-scores (higher indicates better performance). Biomarkers included GlycA, Diabetes Risk Index (DRI), Lipoprotein Insulin Resistance Index (LP-IR), branched-chain amino acids, and betaine. Multiple linear regression examined associations between metabolic markers and T-scores, adjusting for covariates.
Results. Participants had a mean age of 55.7 years (71.0% male). GlycA levels were higher in individuals with diabetes (p = 0.001). Higher DRI levels were associated with worse global T-scores (standardized β = -0.27, p = 0.009).
Higher LP-IR was associated with worse cognitive performance in PWH, but not in PWoH (interaction p = 0.007).