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首页> 外文期刊>Journal of neurology >Microalbuminuria: a sentinel of neurocognitive impairment in HIV-infected individuals?
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Microalbuminuria: a sentinel of neurocognitive impairment in HIV-infected individuals?

机译:微蛋氨酸:艾滋病毒感染个体中神经认知障碍的哨兵?

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Background According to population-based studies, microalbuminuria is associated with subsequent cognitive decline over a 4-6-year period, because of cerebral small-vessel disease (CSVD). This prospective cross-sectional study (NCT02852772) was designed to evaluate whether a history of microalbuminuria is associated with subsequent cognitive decline in combined antiretroviral therapy (cART)-treated persons living with human immunodeficiency virus (PLHIVs). Methods From our computerized medical database, we identified 30 PLHIVs (median age 52 years), immunovirologically controlled on cART, who had microalbuminuria in 2008 and had undergone, between 2013 and 2015, a comprehensive neuropsychological assessment (NPA) including seven domains (cases): information-processing speed, motor skills, executive functions, attention/working memory, learning/memory, reasoning and verbal fluency. Forty-nine PLHIVs matched for age (median age 48 years; p = 0.19), sex, and year of first HIV-seropositivity without microalbuminuria in 2008 were identified and underwent the same NPA between 2013 and 2015 (controls). Results Cases performed less well than controls for information-processing speed (p = 0.01) and motor skills (p = 0.02), but no differences were found for the other cognitive domains and global z-scores. A multivariable linear-regression model adjusted for confounding factors confirmed the microalbuminuria effect for the information-processing-speed z score. Conclusion cART-treated PLHIVs with a history of microalbuminuria subsequently had worse cognitive performances for the information-processing-speed domain, possibly because of CSVD. Our observations should be considered preliminary findings of a temporal link between microalbuminuria, CSVD, and subsequent cognitive impairment.
机译:背景技术根据基于人群的研究,由于脑小血管疾病(CSVD),微白蛋白尿与4-6期内的后续认知下降有关。该预期横截面研究(NCT02852772)旨在评估微蛋白尿的历史与随后与人类免疫缺陷病毒(PLHIVs)一起治疗的组合抗逆转录病毒治疗(购物车)的认知下降相关。方法从我们的计算机化医疗数据库中,我们确定了30个Plhivs(中位年龄52岁),在2008年进行微生物蛋氨酸的购物车,在2013年和2015年在2013年至2015年之间进行了免疫药科学控制,其中包括七个域(案件)的综合性神经心理学评估(NPA) :信息处理速度,电机技能,执行功能,注意/工作记忆,学习/记忆,推理和口头流畅。符合年龄(48岁的中位数48岁; P = 0.19),2008年不含微白蛋白尿的性别和第一次艾滋病毒血清阳性的年度,并在2013年至2015年间接受了相同的NPA(控制)。结果案例比信息处理速度(P = 0.01)和电机技能更少于控制(P = 0.02),但对其他认知域和全局Z分数没有发现差异。调整用于混杂因子的多变量线性回归模型证实了用于信息处理速度Z分数的微量白蛋白尿效应。结论带有微蛋白尿历史的推车处理的PLHIVs随后对信息处理速度域具有更差的认知性能,可能是因为CSVD。我们的观察结果应被视为微白蛋白尿,CSVD和随后的认知障碍之间的时间链路的初步发现。

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