Metabolomic levels mediate the link between socioeconomic factors and changes in declarative memory in women with and without HIV.

Introduction: Understanding metabolic pathways linking socioeconomic conditions and declarative memory (DM) may reveal interventional targets. Methods: Using multivariable generalized estimating equation models in a subsample of the Women's Interagency HIV Study, we examined associations between peripheral metabolomic profiles and longitudinal performance on the Hopkins Verbal Learning Test-Revised (HVLT-R), a measure of DM in the overall sample and by serostatus. We also explored metabolite-mediated effects of income and employment on DM. Results: In a sample of 324 women, 225 with HIV, average age 43.1 years, (65%) non-Hispanic Black. After false discovery rate [FDR]-correction, 15 metabolites were found to relate to learning and 16 to memory changes. Observed effect sizes were generally similar by serostatus. Top metabolites include serotonin, taurine, and niacinamide. In mediation analyses including all women, we found that 30% (95%CI: 4.4%-101.3%) of the effect of employment and 18.2% (95%CI: 2.1% to 72.3%) of the effect of income on learning was mediated through differences in metabolite levels. Discussion: Metabolites mediate the effect of socioeconomic conditions on changes in DM in women.