Sala Michiel, van der Grond Jeroen, de Mutsert Renée, van Heemst Diana, Slagboom P Eline, Kroft Lucia J M, de Roos Albert
1 Department of Radiology, C3-Q, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
2 Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands.
AJR Am J Roentgenol. 2016 May;206(5):1087-92. doi: 10.2214/AJR.15.15251. Epub 2016 Mar 21.
Obesity has been related to structural brain abnormalities. Increasing evidence suggests that accumulation of fat in the liver is an important determinant of cardiometabolic complications of obesity. The purpose of this study was to investigate the association between CT-assessed liver-to-spleen attenuation ratio as a measure of liver steatosis and MRI-assessed brain tissue integrity in middle-aged to elderly persons.
CT and MRI were performed on 213 participants (114 women, 99 men; mean age, 65 ± 7 years). Brain tissue integrity was assessed by magnetization transfer imaging. Linear regression analysis was adjusted for age, sex, vascular risk factors, and total body fat estimated from bioelectrical impedance analysis.
Seventy-nine participants had normal weight (body mass index [BMI], 18.5-24.9), and 134 were overweight (BMI ≥ 25). Significant interaction was found between liver-to-spleen ratio and BMI (p = 0.001). In the overweight group, liver fat was associated with reduced brain tissue integrity in both gray matter (standardized β = 0.22; 95% CI, 0.07-0.36) and white matter (standardized β = 0.31; 95% CI, 0.15-0.45). These associations were not found in the normal weight group (gray matter standardized β = -0.08; 95% CI, -0.33 to 0.16; white matter standardized β = -0.09; 95% CI, -0.36-0.14).
The results indicate that liver fat assessed with CT relates to MRI markers of incipient brain injury in middle-aged to elderly overweight persons.
肥胖与脑结构异常有关。越来越多的证据表明,肝脏脂肪堆积是肥胖相关心血管代谢并发症的一个重要决定因素。本研究的目的是调查在中老年人中,作为肝脂肪变性指标的CT评估的肝脾衰减比与MRI评估的脑组织完整性之间的关联。
对213名参与者(114名女性,99名男性;平均年龄65±7岁)进行了CT和MRI检查。通过磁化传递成像评估脑组织完整性。线性回归分析对年龄、性别、血管危险因素以及通过生物电阻抗分析估算的全身脂肪进行了校正。
79名参与者体重正常(体重指数[BMI],18.5 - 24.9),134名超重(BMI≥25)。发现肝脾比与BMI之间存在显著交互作用(p = 0.001)。在超重组中,肝脏脂肪与灰质(标准化β = 0.22;95%CI,0.07 - 0.36)和白质(标准化β = 0.31;95%CI,0.15 - 0.45)的脑组织完整性降低相关。在体重正常组中未发现这些关联(灰质标准化β = -0.08;95%CI,-0.33至0.16;白质标准化β = -0.09;95%CI,-0.36 - 0.14)。
结果表明,CT评估的肝脏脂肪与中老年超重人群早期脑损伤的MRI标志物有关。