Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, USA.
Neuroimage. 2011 Feb 14;54(4):2659-71. doi: 10.1016/j.neuroimage.2010.10.050. Epub 2010 Oct 28.
We examined how wide ranges in levels of risk factors for cerebrovascular disease are associated with thickness of the human cerebral cortex in 115 individuals ages 43-83 with no cerebrovascular or neurologic history. Cerebrovascular risk factors included blood pressure, cholesterol, body mass index, creatinine, and diabetes-related factors. Variables were submitted into a principal components analysis that confirmed four orthogonal factors (blood pressure, cholesterol, cholesterol/metabolic and glucose). T1-weighted MRI was used to create models of the cortex for calculation of regional cortical thickness. Increasing blood pressure factor scores were associated with numerous regions of reduced thickness. Increasing glucose scores were modestly associated with areas of regionally decreased thickness. Increasing cholesterol scores, in contrast, were associated with thicker cortex across the whole brain. All findings were primarily independent of age. These results provide evidence that normal and moderately abnormal levels of parameters used to assess cerebrovascular health may impact brain structure, even in the absence of cerebrovascular disease. Our data have important implications for the clinical management of vascular health, as well as for what is currently conceptualized as "normal aging" as they suggest that subclinical levels of risk may impact cortical gray matter before a disease process is evident.
我们研究了 115 名年龄在 43-83 岁之间、无脑血管或神经病史的个体中，脑血管病危险因素水平的广泛差异与大脑皮质厚度之间的关系。脑血管病危险因素包括血压、胆固醇、体重指数、肌酐和与糖尿病相关的因素。将变量提交给主成分分析，确认了四个正交因子（血压、胆固醇、胆固醇/代谢和葡萄糖）。T1 加权 MRI 用于创建皮质模型，以计算区域皮质厚度。血压因子得分的增加与多个区域的皮质厚度减少有关。葡萄糖分数的增加与区域性皮质厚度降低的区域适度相关。相比之下，胆固醇分数的增加与整个大脑的皮质增厚有关。所有发现主要独立于年龄。这些结果为评估脑血管健康的参数的正常和中度异常水平可能影响大脑结构提供了证据，即使在没有脑血管疾病的情况下也是如此。我们的数据对血管健康的临床管理具有重要意义，因为它们表明，在疾病过程明显之前，亚临床风险水平可能会影响大脑灰质，这与目前被认为是“正常衰老”的概念相矛盾。
