Kim Hojeong, Kim Changsoo, Seo Sang Won, Na Duk L, Kim Hee Jin, Kang Mira, Shin Hee-Young, Cho Seong Kyung, Park Sang Eon, Lee Jeongmin, Hwang Jung Won, Jeon Seun, Lee Jong-Min, Kim Geon Ha, Cho Hanna, Ye Byoung Seok, Noh Young, Yoon Cindy W, Guallar Eliseo
Samsung Advanced Institute for Health Sciences and Technology,Sungkyunkwan University,Seoul,South Korea.
Department of Preventive Medicine,Yonsei University College of Medicine,Seoul,South Korea.
Int Psychogeriatr. 2015 Jan;27(1):121-30. doi: 10.1017/S1041610214001744. Epub 2014 Sep 29.
There is increasing evidence of a relationship between underweight or obesity and dementia risk. Several studies have investigated the relationship between body weight and brain atrophy, a pathological change preceding dementia, but their results are inconsistent. Therefore, we aimed to evaluate the relationship between body mass index (BMI) and cortical atrophy among cognitively normal participants.
We recruited cognitively normal participants (n = 1,111) who underwent medical checkups and detailed neurologic screening, including magnetic resonance imaging (MRI) in the health screening visits between September 2008 and December 2011. The main outcome was cortical thickness measured using MRI. The number of subjects with five BMI groups in men/women was 9/9, 148/258, 185/128, 149/111, and 64/50 in underweight, normal, overweight, mild obesity, and moderate to severe obesity, respectively. Linear and non-linear relationships between BMI and cortical thickness were examined using multiple linear regression analysis and generalized additive models after adjustment for potential confounders.
Among men, underweight participants showed significant cortical thinning in the frontal and temporal regions compared to normal weight participants, while overweight and mildly obese participants had greater cortical thicknesses in the frontal region and the frontal, temporal, and occipital regions, respectively. However, cortical thickness in each brain region was not significantly different in normal weight and moderate to severe obesity groups. Among women, the association between BMI and cortical thickness was not statistically significant.
Our findings suggested that underweight might be an important risk factor for pathological changes in the brain, while overweight or mild obesity may be inversely associated with cortical atrophy in cognitively normal elderly males.
体重过轻或肥胖与痴呆风险之间的关系证据越来越多。多项研究调查了体重与脑萎缩（痴呆前的一种病理变化）之间的关系，但其结果并不一致。因此，我们旨在评估认知正常参与者的体重指数（BMI）与皮质萎缩之间的关系。
我们招募了认知正常的参与者（n = 1111），他们在2008年9月至2011年12月的健康筛查就诊中接受了医学检查和详细的神经学筛查，包括磁共振成像（MRI）。主要结局是使用MRI测量的皮质厚度。男性/女性五个BMI组的受试者数量在体重过轻、正常、超重、轻度肥胖和中度至重度肥胖组中分别为9/9、148/258、185/128、149/111和64/50。在对潜在混杂因素进行调整后，使用多元线性回归分析和广义相加模型检查BMI与皮质厚度之间的线性和非线性关系。
在男性中，与正常体重参与者相比，体重过轻的参与者在额叶和颞叶区域显示出明显的皮质变薄，而超重和轻度肥胖的参与者在额叶区域以及额叶、颞叶和枕叶区域分别有更大的皮质厚度。然而，正常体重和中度至重度肥胖组在每个脑区的皮质厚度没有显著差异。在女性中，BMI与皮质厚度之间的关联无统计学意义。
我们的研究结果表明，体重过轻可能是大脑病理变化的一个重要危险因素，而超重或轻度肥胖可能与认知正常的老年男性的皮质萎缩呈负相关。
