Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei, 10055, Taiwan.
Department of Neurology, National Taiwan University Hospital, No. 1, Changde Street, Taipei, 10048, Taiwan.
Sci Rep. 2017 May 24;7(1):2337. doi: 10.1038/s41598-017-02537-y.
Chronic kidney disease has been linked to cognitive impairment and morphological brain change. However, less is known about the impact of kidney functions on cerebral cortical thickness. This study investigated the relationship between kidney functions and global or lobar cerebral cortical thickness (CTh) in 259 non-demented elderly persons. Forty-three participants (16.7%) had kidney dysfunction, which was defined as either a glomerular filtration rate (GFR) of <60 ml/min/1.73 m or presence of proteinuria. Kidney dysfunction was associated with lower global (β = -0.05, 95% CI = -0.08 to -0.01) as well as frontal, parietal, temporal, occipital, and insular lobar CTh. In the stratified analysis, the associations were more pronounced in women, APOEε4 non-carriers, and participants with a lower cognitive score. Besides, kidney dysfunction significantly increased the risk of cortical thinning, defined as being the lowest CTh tertile, in the insular lobe (adjusted odds ratio = 2.74, 95% CI = 1.31-5.74). Our results suggested that kidney dysfunction should be closely monitored and managed in elderly population to prevent neurodegeneration.
慢性肾脏病与认知障碍和大脑形态改变有关。然而，关于肾脏功能对大脑皮质厚度的影响知之甚少。本研究调查了 259 名非痴呆老年人的肾脏功能与全脑或脑叶皮质厚度（CTh）之间的关系。43 名参与者（16.7%）存在肾功能障碍，定义为肾小球滤过率（GFR）<60ml/min/1.73m 或蛋白尿。肾功能障碍与全脑皮质厚度（β=-0.05，95%CI=-0.08 至-0.01）以及额、顶、颞、枕和脑岛叶皮质厚度呈负相关。在分层分析中，这些关联在女性、APOEε4 非携带者和认知评分较低的参与者中更为明显。此外，肾功能障碍显著增加了脑岛叶皮质变薄的风险，定义为皮质厚度最低的三分之一（调整后的优势比=2.74，95%CI=1.31-5.74）。我们的研究结果表明，老年人应密切监测和管理肾功能障碍，以预防神经退行性变。
