1 Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
2 Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
Vasc Med. 2018 Jun;23(3):212-218. doi: 10.1177/1358863X18755004. Epub 2018 Feb 28.
Impaired microvascular endothelial function may be implicated in the etiology of cognitive decline. Yet, current data on this association are inconsistent. Our objective is to investigate the relation of microvascular endothelial function to cognitive performance in the ELSA-Brasil cohort study. A total of 1521 participants from ELSA-Brasil free of dementia underwent peripheral arterial tonometry (PAT) to quantify microvascular endothelial function (PAT-ratio and mean baseline pulse amplitude (BPA)) and cognitive tests that covered the domains of memory, verbal fluency, and executive function at baseline. Cognitive tests in participants aged 55 years old and above were repeated during the second examination (mean follow-up: 3.5 (0.3) years). Linear regression and generalized linear models were used to evaluate the association between endothelial function, global cognitive performance, and performance on specific cognitive domains. In unadjusted cross-sectional analyses, we found that BPA and PAT-ratio were associated with worse global cognitive performance (mean difference for BPA: -0.07, 95% CI: -0.11; -0.03, p<0.01; mean difference for PAT-ratio: 0.11, 95% CI: 0.01; 0.20, p=0.02), worse performance on learning, recall, and word recognition tests (BPA: -0.87, 95% CI: -1.21; -0.52, p<0.01; PAT-ratio: 1.58, 95% CI: 0.80; 2.36, p<0.01), and only BPA was associated with worse performance in verbal fluency tests (-0.70, 95% CI: -1.19; -0.21, p<0.01). Adjustments for age, sex, and level of education rendered the associations statistically non-significant. Longitudinally, there was no association between microvascular endothelial and cognitive functions. The associations between microvascular endothelial function and cognition are explained by age, sex, and educational level. Measures of microvascular endothelial function may be of limited value with regard to preclinical cognitive deficits.
微血管内皮功能障碍可能与认知能力下降的病因有关。然而，目前关于这种关联的数据并不一致。我们的目的是在 ELSA-Brasil 队列研究中调查微血管内皮功能与认知表现之间的关系。共有 1521 名来自 ELSA-Brasil 的无痴呆症参与者接受了外周动脉张力测量（PAT），以量化微血管内皮功能（PAT 比值和平均基线脉搏振幅（BPA）），并在基线时进行了涵盖记忆、语言流畅性和执行功能领域的认知测试。年龄在 55 岁及以上的参与者在第二次检查时（平均随访时间：3.5（0.3）年）重复进行认知测试。线性回归和广义线性模型用于评估内皮功能、整体认知表现和特定认知领域表现之间的关系。在未经调整的横断面分析中，我们发现 BPA 和 PAT 比值与较差的整体认知表现相关（BPA 的平均差异：-0.07，95%CI：-0.11；-0.03，p<0.01；PAT 比值的平均差异：0.11，95%CI：0.01；0.20，p=0.02），学习、回忆和单词识别测试的表现更差（BPA：-0.87，95%CI：-1.21；-0.52，p<0.01；PAT 比值：1.58，95%CI：0.80；2.36，p<0.01），只有 BPA 与语言流畅性测试的表现更差相关（-0.70，95%CI：-1.19；-0.21，p<0.01）。调整年龄、性别和教育水平后，关联在统计学上不再显著。纵向来看，微血管内皮和认知功能之间没有关联。微血管内皮功能与认知之间的关联可通过年龄、性别和教育水平来解释。微血管内皮功能的测量值对于临床前认知缺陷可能没有多大价值。
