scholarly journals Metabolic Risk Factors as Differential Predictors of Profiles of Neurocognitive Impairment Among Older HIV+ and HIV− Adults: An Observational Study

2019 ◽  
Author(s):  
Elizabeth C Pasipanodya ◽  
Jessica L Montoya ◽  
Laura M Campbell ◽  
Mariam A Hussain ◽  
Rowan Saloner ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Probability ◽  
Latent Class ◽  
Neurocognitive Impairment ◽  
Metabolic Risk Factors ◽  
People Living With Hiv ◽  
Significant Heterogeneity ◽  
Metabolic Risk ◽  
Multinomial Regression ◽  
Living With Hiv

Abstract Objective Neurocognitive performance among older persons, including those living with HIV (people living with HIV [PLWH]), exhibits significant heterogeneity, suggesting subpopulations with differing profiles of neurocognitive impairment (NCI). Metabolic factors are associated with NCI, but their relationships to cluster-derived NCI profiles are unknown. Method Participants (144 PLWH and 102 HIV uninfected) aged 50+ years completed a neuropsychological battery assessing seven cognitive domains. Latent class analysis (LCA) identified NCI profiles separately by HIV serostatus and in a combined sample. Obtained classes were examined against the Montreal Cognitive Assessment (MoCA) and diagnoses of HIV-associated neurocognitive disorders (HAND). Multinomial regression identified metabolic predictors of classification. Results LCA identified three latent classes in each participant sample: Class1Multidomain NCI (high probability of impairment across multiple domains), Class 2Learning & Recall NCI (high probability of impairment in learning and recall), and Class 3NC Unimpaired (low probability of NCI across all domains). Severity of NCI implied by classes corresponded with MoCA scores and HAND diagnoses. In analyses on the combined sample, compared to HIV-uninfected individuals, PLWH were more likely to be in Class1Multidomain NCI. Among PLWH, those with dyslipidemia and hypertension had greater odds of classification in Class 1Multidomain NCI while those with central obesity had higher odds of classification in Class 2Learning & Recall NCI; metabolic syndrome approached significance as a differential predictor. Regardless of HIV status, individuals with diabetes were more likely to be in Class 1Multidomain NCI. Conclusions Metabolic risk factors confer heightened risk of NCI in HIV infection. Interventions to reduce metabolic risk may improve neurocognitive outcomes among PLWH.

scholarly journals Metabolic risk factors and risk of Covid-19: A systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243600
Author(s):  
Bahram Moazzami ◽  
Shahla Chaichian ◽  
Amir Kasaeian ◽  
Shirin Djalalinia ◽  
Meisam Akhlaghdoust ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Metabolic Risk Factors ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Metabolic Risk ◽  
Services Delivery ◽  
Obesity And Diabetes ◽  
Pooled Prevalence

Objective Based on the epidemiologic findings of Covid-19 incidence; illness and mortality seem to be associated with metabolic risk factors. This systematic review and meta-analysis aimed to assess the association of metabolic risk factors and risk of Covid-19. Methods This study was designed according to PRISMA guidelines. Two independent researchers searched for the relevant studies using PubMed, Web of Science, Cochrane Library, and Scopus. The search terms developed focusing on two main roots of “Covid-19” and “metabolic risk factors”. All relevant observational, analytical studies, review articles, and a meta-analysis on the adult population were included in this meta-analysis. Meta-analysis was performed using the random effect model for pooling proportions to address heterogeneity among studies. Data were analyzed using STATA package version 11.2, (StataCorp, USA). Results Through a comprehensive systematic search in the targeted databases we found 1124 papers, after running the proses of refining, 13 studies were included in the present meta-analysis. The pooled prevalence of obesity in Covid-19 patients was 29% (95% CI: 14–47%). For Diabetes and Hypertension, these were 22% (95% CI: 12% 33%) and 32% (95% CI: 12% 56%), respectively. There was significant heterogeneity in the estimates of the three pooled prevalence without any significant small-study effects. Such warning points, to some extent, guide physicians and clinicians to better understand the importance of controlling co-morbid risk factors in prioritizing resource allocation and interventions. Conclusion The meta-analysis showed that hypertension is more prevalent than obesity and diabetes in patients with Covid-19 disease. The prevalence of co-morbid metabolic risk factors must be adopted for better management and priority settings of public health vaccination and other required interventions. The results may help to improve services delivery in COVID-19 patients, while helping to develop better policies for prevention and response to COVID-19 and its critical outcomes.

Effect of Exercise on Cardiac and Metabolic Outcomes in People Living With HIV

2013 ◽  
Vol 31 (1) ◽  
pp. 277-296 ◽  
Author(s):  
Anella Yahiaoui ◽  
Barbara A. Smith ◽  
Joachim G. Voss
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
High Stress ◽  
Individual Factors ◽  
People Living With Hiv ◽  
Metabolic Risk ◽  
Metabolic Outcomes ◽  
Lifestyle Choices ◽  
Living With Hiv

Poorly controlled HIV infection and antiretroviral therapy, especially the use of protease inhibitors, are among the causes that contribute to the development of cardiovascular disease in people living with HIV (PLWH). Poor lifestyle choices (smoking, lack of physical activity, poor diet) and individual factors such as high stress, physical or emotional trauma, depression, and so forth contribute to the overall risk of developing cardiovascular disease. The purpose of this review was to critically evaluate the more recent aerobic and resistance exercise studies and their impact on cardiovascular and metabolic risk factors in PLWH.

Correlation of Metabolic Risk Factors with Sessile Serrated Lesions

2020 ◽  
Vol 29 (2) ◽  
pp. 175-179
Author(s):  
Melania Macarie ◽  
Simona Bataga ◽  
Simona Mocan ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Statistical Significance ◽  
Interval Cancer ◽  
Metabolic Risk Factors ◽  
Control Group ◽  
Anatomical Site ◽  
Metabolic Risk ◽  
Right Colon ◽  
Serrated Lesions ◽  
The Right

Background and Aims: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called “interval cancer”, having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. Methods: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps’ development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. Results: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. Conclusions: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.

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