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肥胖指标与阿尔茨海默病相关 MRI 标志物:北方曼哈顿研究。

Measures of Adiposity and Alzheimer's Disease-Related MRI Markers: The Northern Manhattan Study.

机构信息

Division of Epidemiology and Population Health Sciences, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.

Evelyn F. McKnight Brain Institute, University of Miami, Miami, FL, USA.

出版信息

J Alzheimers Dis. 2019;70(4):995-1004. doi: 10.3233/JAD-190092.

Abstract

BACKGROUND

Adiposity may increase risk for dementia and Alzheimer's disease (AD), but mechanisms are unclear.

OBJECTIVE

To examine associations between measures of adiposity with AD-signature region cortical thickness and hippocampal volume.

METHODS

We used data from the Northern Manhattan Study, a clinically stroke-free cohort of mostly Hispanic participants. Exposures of interest included body mass index (BMI), waist-hip-ratio (WHR), waist circumference (WC), and adiponectin concentration, measured at study entry. AD-signature region cortical thickness and hippocampal volume were obtained using Freesurfer. We estimated associations using multivariable linear regression, adjusting for sociodemographics and health behaviors. We re-examined estimates after adjustment for APOEɛ4 allele status or carotid intima-media thickness (cIMT), among those cognitively unimpaired, and after weighting for the inverse probability of selection into the MRI sub-study. We also repeated analyses for cortical thickness in non-AD signature regions.

RESULTS

The sample (N = 947, 63% women, 66% Hispanic/Latino, 26% obese) had a mean (SD) age = 63 (8) years. Greater BMI and WC (both z-scored) were associated with thinner AD-signature region cortex (also z-scored) (BMI: β [95% CI] = -0.09 [-0.18, -0.01], WC: β [95% CI] = -0.11 [-0.20, -0.02]). We did not find evidence that adiposity was related to hippocampal volume. Results were consistent after adjustment for APOEɛ4 allele status or cIMT, after weighting for selection, among those cognitively unimpaired, and for non-AD signature region cortical thickness.

CONCLUSION

Greater BMI and WC were related to cortical thinning within and outside the AD-signature region, suggesting a global effect not specific to AD.

摘要

背景

肥胖可能会增加痴呆和阿尔茨海默病(AD)的风险,但机制尚不清楚。

目的

研究肥胖指标与 AD 特征区域皮质厚度和海马体积之间的关系。

方法

我们使用了来自北方曼哈顿研究的数据,这是一个主要由西班牙裔参与者组成的临床无中风队列。感兴趣的暴露因素包括体重指数(BMI)、腰臀比(WHR)、腰围(WC)和脂联素浓度,这些都是在研究开始时测量的。使用 Freesurfer 获得 AD 特征区域皮质厚度和海马体积。我们使用多变量线性回归来估计关联,调整了社会人口统计学和健康行为因素。在认知正常的人群中,我们在调整 APOEɛ4 等位基因状态或颈动脉内膜中层厚度(cIMT)后重新检查了估计值,并对 MRI 子研究的选择概率进行了加权。我们还对非 AD 特征区域的皮质厚度进行了重复分析。

结果

样本(N=947,63%为女性,66%为西班牙裔/拉丁裔,26%为肥胖)的平均(SD)年龄为 63(8)岁。较高的 BMI 和 WC(均为 z 评分)与 AD 特征区域皮质变薄(也为 z 评分)相关(BMI:β[95%CI]=-0.09[-0.18,-0.01],WC:β[95%CI]=-0.11[-0.20,-0.02])。我们没有发现肥胖与海马体积有关的证据。在调整了 APOEɛ4 等位基因状态或 cIMT、在认知正常的人群中调整了选择概率、对 MRI 子研究进行了加权后,以及对非 AD 特征区域的皮质厚度进行了分析后,结果仍然一致。

结论

较高的 BMI 和 WC 与 AD 特征区域内外的皮质变薄有关,这表明存在一种非特异性的 AD 影响。

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