PDF(Pubmed)
Abstract：
With people living with HIV (PLWH) reaching the senium, the importance of aging-related comorbidities such as metabolic syndrome (MS) becomes increasingly important. This study aimed to determine the additive effect of MS on brain atrophy in PLWH. This prospective study included 43 PLWH, average age of 43.02 ± 10.93 years, and 24 healthy controls, average age of 36.87 ± 8.89 years. PLWH were divided into two subgroups: without MS and with MS, according to NCEP ATP III criteria. All patients underwent brain magnetic resonance imaging (MRI) on a 3T clinical scanner with MR volumetry, used for defining volumes of cerebrospinal fluid (CSF) spaces and white and grey matter structures, including basal ganglia. A Student\'s t-test was used to determine differences in brain volumes between subject subgroups. The binary classification was performed to determine the sensitivity and specificity of volumetry findings and cut-off values. Statistical significance was set at p < 0.05. PLWH presented with significantly lower volumes of gray matter, putamen, thalamus, globus pallidus, and nc. accumbens compared to healthy controls; cut-off values were: for gray matter 738.130 cm3, putamen 8.535 cm3, thalamus 11.895 cm3, globus pallidus 2.252 cm3, and nc. accumbens 0.715 cm3. The volumes of CSF and left lateral ventricles were found to be higher in PLWH with MS compared to those without MS, where, with a specificity of 0.310 and sensitivity of 0.714, it can be assumed that PLWH with a CSF volume exceeding 212.83 cm3 are likely to also have MS. This suggests that PLWH with metabolic syndrome may exhibit increased CSF volume above 212.83 cm3 as a consequence of brain atrophy. There seems to be an important connection between MS and brain volume reduction in PLWH with MS, which may add to the accurate identification of persons at risk of developing HIV-associated cognitive impairment.
摘要：
随着艾滋病毒携带者（PLWH）达到衰老，与衰老相关的合并症如代谢综合征(MS)的重要性变得越来越重要.本研究旨在确定MS对PLWH脑萎缩的累加作用。这项前瞻性研究包括43PLWH，平均年龄43.02±10.93岁，和24个健康对照，平均年龄36.87±8.89岁。PLWH分为两个亚组：无MS和有MS，根据NCEPATPIII标准。所有患者在具有MR容积的3T临床扫描仪上接受了脑磁共振成像（MRI），用于定义脑脊液（CSF）空间以及白质和灰质结构的体积，包括基底神经节.使用学生t检验来确定受试者亚组之间脑体积的差异。进行二元分类以确定体积测量结果和截止值的敏感性和特异性。统计学显著性设定为p<0.05。PLWH呈现明显较低的灰质体积，壳核,丘脑,苍白球,nc。与健康对照组相比；截止值为：灰质738.130cm3，壳核8.535cm3，丘脑11.895cm3，苍白球2.252cm3和nc。伏隔0.715cm3。与没有MS的患者相比，发现有MS的PLWH的CSF和左心室体积更高，where,特异性为0.310，灵敏度为0.714，可以假设CSF体积超过212.83cm3的PLWH也可能患有MS。这表明患有代谢综合征的PLWH可能由于脑萎缩而表现出超过212.83cm3的CSF体积增加。MS与PLWH合并MS的脑容量减少之间似乎存在重要联系，这可能会增加对有HIV相关认知障碍风险的人的准确识别。
