HIV感染者代谢综合征及其组分与神经认知损伤关联研究系统综述

为了解人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者代谢综合征(metabolic syndrome, MS)与神经认知损伤关联研究现状，系统检索Ovid Medline、Embase、中国知网、维普中文期刊服务平台、万方数据知识服务平台等数据库1992-2019年间发表的关于HIV感染者MS与神经认知损伤关联的原创性研究文献并对符合纳入排除标准文献进行分析归纳总结。最终共纳入22篇文献，包括14篇横断面研究、7篇队列研究和1篇二手资料分析；其中10篇研究纳入了HIV阴性人群对照。根据量表评估神经认知损伤程度，指标主要为测试分数。综述结果显示，HIV感染者代谢紊乱较普遍，神经认知损伤患病率存在较大的地区差异；HIV感染者MS与神经认知损伤风险增加相关。由于各研究采用不同量表对神经认知及单个功能领域损伤进行评估，不同研究中MS组分与神经认知及各功能领域之间关联复杂，不同功能领域结果甚至存在较大差异。HIV感染者代谢紊乱可能与神经认知功能不同领域损伤风险增加有关。鉴于目前研究证据有限且主要集中在欧美发达国家，需要更多其它地区及发展中国家的研究证据。

Systematic review of association between metabolic syndrome and its components with neurocognitive impairment among HIV-infected population

To systematically review the literature about the association between metabolic syndrome (MS) and neurocognitive impairments (NCIs) among human immunodeficiency virus (HIV) infected patients. We systematically searched and reviewed related literature published on databases of Ovid Medline, Embase, CNKI, CQVIP and Wanfang Data from 1992 to 2019. Information excerpted from papers that met the inclusion and exclusion criteria were analyzed. A total of 22 articles were included, including 14 cross-sectional studies, seven cohort studies and one secondary analysis, which were mainly conducted in the United States. HIV-negative controls were included in ten studies. NCIs were assessed by using neuropsychological battery. Metabolic disturbance was prevalent and NCIs was also prevalent with obvious heterogeneity across different geographic areas. Summarized results suggested that MS was associated with increased risk of NCIs. In consideration of different scales applied in different studies for the neurocognitive assessment and related ability domains, the relationship between MS components and NCIs and/or ability domains was found to be complicated. Some of these studies revealed distinct differences in ability domains evaluation. Metabolic disturbance may increase risks of various aspects of NCIs in HIV patients. In view of the limited evidence, more research is needed in other regions and developing countries.