A Longitudinal Study of Baseline Fatty Acid Concentrations and Executive Function Over 12 Months Among Adolescents With and Without Perinatal HIV Exposure or Infection From Kampala, Uganda.

BACKGROUND

Adolescence is critical for executive function development, and fatty acids, vital for brain development, may influence this process. This influence is understudied in populations affected by HIV, where malnutrition and neuroinflammation persist.

OBJECTIVES

This study aimed to determine associations between serum fatty acid concentrations and executive function in Ugandan adolescents over 12 mo and evaluate modification by perinatal HIV status. It was hypothesized that PUFA concentrations were associated with improved executive function, whereas SFA concentrations were associated with worse executive function, especially in adolescents affected by perinatal HIV exposure/infection.

METHODS

Adolescents with perinatal HIV infection (APHIV; n = 122), adolescents perinatally exposed to but uninfected with HIV (AHEU; n = 130), and adolescents perinatally unexposed to and uninfected with HIV (AHUU; n = 123) were analyzed. Serum fatty acid concentrations were measured at baseline. Questionnaire- and performance-based measures of executive function (analyzed as z-scores) were assessed at baseline and 6 and 12 mo. Linear mixed-effects models were used to analyze associations between baseline serum fatty acid tertiles and repeated executive function measures. Mean differences (MDs) and their 95% CIs are reported.

RESULTS

Among all adolescents, moderate compared with low ω-3 PUFA levels were associated with decreases in self-report executive dysfunction (total ω-3 PUFA-MD: -0.51; 95% CI: - 0.87, -0.15; Omega-3 Index-MD: -0.52; 95% CI: -0.88, -0.16; highly unsaturated fatty acid ratio-MD: -0.42; 95% CI: -0.79, -0.06; DHA-MD: -0.58; 95% CI: -0.94, -0.21). Among APHIV, high EPA (MD: 1.07; 95% CI: 0.27, 1.87) and select SFA concentrations (arachidic acid-MD: 0.86; 95% CI: 0.38, 1.34; behenic acid-MD: 0.76; 95% CI: 0.23, 1.29; lignoceric acid-MD: 0.78; 95% CI: 0.24, 1.31) correlated with increased self-report and performance-based executive dysfunction, respectively.

CONCLUSIONS

Overall, higher ω-3 PUFA concentrations are associated with better questionnaire-based executive function, but high EPA and SFA concentrations are associated with worse executive function among APHIV. These findings support the potential of ω-3 PUFAs to improve executive function in vulnerable populations and highlight the importance of further studying the relationship between fatty acids and executive function among APHIV.