Browsing by Author "Osuwat, Lawrence Obado"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Association of high serum aspartate transaminase to high density lipoproteincholesterol ratio with probable dementia among people living with HIV on antiretroviral therapy in Southwestern Uganda
    (Sage, 2025-08-11) Bagenda, Charles Nkubi; Mudondo, Hope; Ssemwanga, Elastus; Nzaramba, Daniel; Ssedyabane, Frank; Ojuko, Samuel; Musinguzi, Benson; Akiteng, Winnie; Agaba, Bosco Bekiita; Osuwat, Lawrence Obado; Maling, Samuel; Rugera, Simon Peter; Tusubira, Deusdedit
    Objectives: Previous studies present conflicting evidence on the relationship between hepatocellular damage biomarkers and dementia risk. While elevated serum transaminases have been associated with mild cognitive impairment, other studies link lower transaminase levels and reduced high-density lipoprotein-cholesterol levels to increased risk of cognitive decline. This study investigated the association between serum transaminase-to-high-density lipoprotein-cholesterol ratios and probable dementia among people living with HIV on antiretroviral therapy. Methods: We conducted a secondary data analysis using a dataset from a cross-sectional study conducted among 377 people living with HIV on dolutegravir-based antiretroviral therapy in southwestern Uganda. Probable dementia was screened using the brief Community Screening Instrument for Dementia and defined as a Community Screening Instrument for Dementia cognitive score ⩽4. Serum alanine aminotransferase/high-density lipoprotein-cholesterol and aspartate aminotransferase/high-density lipoprotein-cholesterol ratios were calculated from the respective serum transaminases and high-density lipoprotein-cholesterol divided into tertiles. We used logistic regression to assess the association between the independent variables and probable dementia. Results: The median age of the study participants was 44 years (interquartile range: 30–59), with 56.2% being female. The median total cholesterol/high-density lipoprotein-cholesterol levels were significantly higher in participants with probable dementia compared to those without (3.86 versus 3.22, p = 0.03). Aspartate aminotransferase/high-density lipoprotein-cholesterol and alanine aminotransferase/high-density lipoprotein-cholesterol levels were also higher among participants with probable dementia compared to those without, although the differences did not reach statistical significance. In the fully adjusted model, compared to participants in the first tertile of aspartate aminotransferase/high-density lipoprotein-cholesterol ratio, the odds of probable dementia were higher in the second tertile (adjusted odds ratio: 1.71; 95% confidence interval: 0.62–4.74; p = 0.301) and significantly elevated in the third tertile (adjusted odds ratio: 4.48; 95% confidence interval: 1.15–17.46; p = 0.031). Conclusions: The findings suggest that an elevated aspartate aminotransferase/high-density lipoprotein-cholesterol ratio is significantly associated with probable dementia among people living with HIV on dolutegravir-based antiretroviral therapy. A high aspartate aminotransferase/high-density lipoprotein-cholesterol ratio is potentially associated with cognitive decline in this population.
  • Thumbnail Image
    Item
    Total cholesterol/high-density lipoprotein cholesterol ratio is a significant predictor of metabolic syndrome among people on dolutegravir-based antiretroviral therapy: A cross-sectional study in southwestern Uganda
    (Sage, 2025-08-29) Bagenda, Charles Nkubi; Nantongo, Carol; Ssemwanga, Elastus; Mugisa, Michael Junior; Ojuko, Samuel; Sempijja, Fred; Nzaramba, Daniel; Kiconco, Ritah; Ssedyabane, Frank; Musinguzi, Benson; Akiteng, Winnie; Tusubira, Deusdedit; Osuwat, Lawrence Obado; Rugera, Simon Peter
    Objective: The total cholesterol/high-density lipoprotein cholesterol ratio is a predictor of nonalcoholic fatty liver disease—a hepatic manifestation of metabolic syndrome. This study investigated the association between total cholesterol/high-density lipoprotein cholesterol ratio and metabolic syndrome among people living with human immunodeficiency virus on dolutegravir-based antiretroviral therapy in southwestern Uganda. Methods: We conducted a secondary analysis of data obtained from a cross-sectional study of 377 adults who had been on dolutegravir-based antiretroviral therapy for at least 1 year at Ruhoko Health Centre IV, southwestern Uganda. Results: The median total cholesterol/high-density lipoprotein cholesterol ratio was significantly higher in individuals with metabolic syndrome (3.92) than in those without (2.96, p < 0.001). A statistically significant association was observed between high total cholesterol/high-density lipoprotein cholesterol ratio and metabolic syndrome (adjusted odds ratios: 2.06, 95% confidence interval: 1.08–3.91, p 1⁄4 0.028). The total cholesterol/high-density lipoprotein cholesterol ratio at an optimal cutoff of 3.30 had a significant ability (area under the curve 1⁄4 0.696, 95% confidence interval: 0.642–0.750) to differentiate participants with metabolic syndrome from those without at a sensitivity of 73% and specificity of 60%. Conclusion: The total cholesterol/high-density lipoprotein cholesterol ratio is a significant pre-dictor of metabolic syndrome and serves as a potential blood-based biomarker.