An Exploratory Study of Correlates of Allostatic Load in Older People Living With HIV.
Black or African American
Aged
Allostasis
/ physiology
Biomarkers
Body Mass Index
C-Reactive Protein
Cholesterol
Dehydroepiandrosterone
/ blood
Female
HIV Infections
/ complications
Humans
Hydrocortisone
/ blood
Interleukin-6
Male
Middle Aged
Resilience, Psychological
Triglycerides
/ blood
Tumor Necrosis Factor-alpha
/ blood
Journal
Journal of acquired immune deficiency syndromes (1999)
ISSN: 1944-7884
Titre abrégé: J Acquir Immune Defic Syndr
Pays: United States
ID NLM: 100892005
Informations de publication
Date de publication:
15 04 2020
15 04 2020
Historique:
pubmed:
9
1
2020
medline:
30
10
2020
entrez:
9
1
2020
Statut:
ppublish
Résumé
Older people living with HIV (PLWH) experience poorer outcomes than seronegative counterparts. Allostatic load (AL) markers have shown utility as indicators of cumulative wear-and-tear of stress on biological systems. However, little is known about correlates of AL in PLWH. Ninety-six PLWH aged 50+ completed a comprehensive neurobehavioral assessment and blood draw. Select AL markers (ie, 10 blood markers) were available for a subset (n = 75) of seronegative controls. AL was operationalized as a sum of markers in the highest risk quartile for: cortisol, DHEA, IL-6, TNF-alpha, C-reactive protein, glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, albumin, systolic and diastolic blood pressure, and body mass index. PLWH had higher risk levels than seronegatives with small-medium effect sizes for several biomarkers. Among HIV+ African Americans (84% of PLWH), higher AL was associated with lower psychological resilience (rho = -0.27, P = 0.02), less physical activity (rho = -0.29, P < 0.01), poorer neurocognitive functioning (rho = -0.26, P = 0.02), greater basic activity of daily living complaints (P < 0.01), and diabetes (P < 0.01). Multivariable regressions within African American PLWH for significant AL-outcome associations (ie, neurocognitive function, basic activity of daily living complaints, diabetes) showed that associations with AL remained significant when adjusting for relevant covariates. Mediation analysis suggested that the association between socioeconomic status and neurocognitive function was mediated by AL. These exploratory findings are consistent with the larger aging literature, suggesting that lower AL may serve as a pathway to better health and functional outcomes, particularly in African American PLWH. Furthermore, resilience and physical activity may reduce AL in this population.
Sections du résumé
BACKGROUND
Older people living with HIV (PLWH) experience poorer outcomes than seronegative counterparts. Allostatic load (AL) markers have shown utility as indicators of cumulative wear-and-tear of stress on biological systems. However, little is known about correlates of AL in PLWH.
METHODS
Ninety-six PLWH aged 50+ completed a comprehensive neurobehavioral assessment and blood draw. Select AL markers (ie, 10 blood markers) were available for a subset (n = 75) of seronegative controls. AL was operationalized as a sum of markers in the highest risk quartile for: cortisol, DHEA, IL-6, TNF-alpha, C-reactive protein, glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, albumin, systolic and diastolic blood pressure, and body mass index.
RESULTS
PLWH had higher risk levels than seronegatives with small-medium effect sizes for several biomarkers. Among HIV+ African Americans (84% of PLWH), higher AL was associated with lower psychological resilience (rho = -0.27, P = 0.02), less physical activity (rho = -0.29, P < 0.01), poorer neurocognitive functioning (rho = -0.26, P = 0.02), greater basic activity of daily living complaints (P < 0.01), and diabetes (P < 0.01). Multivariable regressions within African American PLWH for significant AL-outcome associations (ie, neurocognitive function, basic activity of daily living complaints, diabetes) showed that associations with AL remained significant when adjusting for relevant covariates. Mediation analysis suggested that the association between socioeconomic status and neurocognitive function was mediated by AL.
CONCLUSIONS
These exploratory findings are consistent with the larger aging literature, suggesting that lower AL may serve as a pathway to better health and functional outcomes, particularly in African American PLWH. Furthermore, resilience and physical activity may reduce AL in this population.
Identifiants
pubmed: 31914006
doi: 10.1097/QAI.0000000000002293
pmc: PMC7424692
mid: NIHMS1549611
pii: 00126334-202004150-00001
doi:
Substances chimiques
Biomarkers
0
IL6 protein, human
0
Interleukin-6
0
Triglycerides
0
Tumor Necrosis Factor-alpha
0
Dehydroepiandrosterone
459AG36T1B
C-Reactive Protein
9007-41-4
Cholesterol
97C5T2UQ7J
Hydrocortisone
WI4X0X7BPJ
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
441-449Subventions
Organisme : NIA NIH HHS
ID : K99 AG048762
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH106366
Pays : United States
Organisme : NIA NIH HHS
ID : R00 AG048762
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG022838
Pays : United States
Organisme : NIAID NIH HHS
ID : R24 AI067039
Pays : United States
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