Park Sang Eon, Kim Hojeong, Lee Jeongmin, Lee Na Kyung, Hwang Jung Won, Yang Jin-ju, Ye Byoung Seok, Cho Hanna, Kim Hee Jin, Kim Yeo Jin, Jung Na-Yeon, Son Tae Ok, Cho Eun Bin, Jang Hyemin, Jang Eun Young, Hong Chang Hyung, Lee Jong-Min, Kang Mira, Shin Hee-Young, Na Duk L, Seo Sang Won
Department of Neurology,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,South Korea.
Department of Biomedical Engineering,Hanyang University,Seoul,South Korea.
Int Psychogeriatr. 2016 Jan;28(1):147-56. doi: 10.1017/S1041610215000733. Epub 2015 May 20.
Decreased hemoglobin levels increase the risk of developing dementia among the elderly. However, the underlying mechanisms that link decreased hemoglobin levels to incident dementia still remain unclear, possibly due to the fact that few studies have reported on the relationship between low hemoglobin levels and neuroimaging markers. We, therefore, investigated the relationships between decreased hemoglobin levels, cerebral small-vessel disease (CSVD), and cortical atrophy in cognitively healthy women and men.
Cognitively normal women (n = 1,022) and men (n = 1,018) who underwent medical check-ups and magnetic resonance imaging (MRI) were enrolled at a health promotion center. We measured hemoglobin levels, white matter hyperintensities (WMH) scales, lacunes, and microbleeds. Cortical thickness was automatically measured using surface based methods. Multivariate regression analyses were performed after controlling for possible confounders.
Decreased hemoglobin levels were not associated with the presence of WMH, lacunes, or microbleeds in women and men. Among women, decreased hemoglobin levels were associated with decreased cortical thickness in the frontal (Estimates, 95% confidence interval, -0.007, (-0.013, -0.001)), temporal (-0.010, (-0.018, -0.002)), parietal (-0.009, (-0.015, -0.003)), and occipital regions (-0.011, (-0.019, -0.003)). Among men, however, no associations were observed between hemoglobin levels and cortical thickness.
Our findings suggested that decreased hemoglobin levels affected cortical atrophy, but not increased CSVD, among women, although the association is modest. Given the paucity of modifiable risk factors for age-related cognitive decline, our results have important public health implications.
血红蛋白水平降低会增加老年人患痴呆症的风险。然而，将血红蛋白水平降低与新发痴呆症联系起来的潜在机制仍不清楚，这可能是因为很少有研究报道低血红蛋白水平与神经影像学标志物之间的关系。因此，我们调查了认知功能正常的女性和男性中血红蛋白水平降低、脑小血管疾病（CSVD）和皮质萎缩之间的关系。
在一个健康促进中心招募了接受医学检查和磁共振成像（MRI）的认知正常的女性（n = 1022）和男性（n = 1018）。我们测量了血红蛋白水平、白质高信号（WMH）量表、腔隙和微出血。使用基于表面的方法自动测量皮质厚度。在控制了可能的混杂因素后进行多变量回归分析。
女性和男性的血红蛋白水平降低与WMH、腔隙或微出血的存在无关。在女性中，血红蛋白水平降低与额叶（估计值，95%置信区间，-0.007，（-0.013，-0.001））、颞叶（-0.010，（-0.018，-0.002））、顶叶（-0.009，（-0.015，-0.003））和枕叶区域（-0.011，（-0.019，-0.003））的皮质厚度降低有关。然而，在男性中，未观察到血红蛋白水平与皮质厚度之间的关联。
我们的研究结果表明，尽管这种关联程度不大，但女性中血红蛋白水平降低会影响皮质萎缩，而不会增加CSVD。鉴于与年龄相关的认知衰退的可改变风险因素很少，我们的结果具有重要的公共卫生意义。
