From the Division of Epidemiology and Population Health Sciences, Department of Public Health Sciences (M.R.C.), Department of Neurology (M.R.C., H.G., M.S., R.L.S., T.R.), and Department of Radiology (N.A.), Miller School of Medicine, and Evelyn F. McKnight Brain Institute (M.R.C., N.A., R.L.S., T.R.), University of Miami, FL; Departments of Biostatistics (Y.K.C.) and Epidemiology (M.S.V.E.), Mailman School of Public Health, and Department of Neurology, Vagelos College of Physicians and Surgeons (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (M.Y.), Hokuriku National Hospital, Nanto, Japan; Department of Neurology (C.D.), University of California, Davis; and National Institute of Neurological Disorders and Stroke (C.B.W.), Bethesda, MD.
Neurology. 2019 Aug 20;93(8):e791-e803. doi: 10.1212/WNL.0000000000007966. Epub 2019 Jul 24.
To examine associations between measures of obesity in middle to early-old age with later-life MRI markers of brain aging.
We analyzed data from the Northern Manhattan MRI Sub-Study (n = 1,289). Our exposures of interest were body mass index (BMI), waist circumference (WC), waist-to-hip ratio, and plasma adiponectin levels. Our outcomes of interest were total cerebral volume (TCV), cortical thickness, white matter hyperintensity volume (WMHV), and subclinical brain infarcts (SBI). Using multivariable linear and logistic regression models adjusted for sociodemographics, health behaviors, and vascular risk factors, we estimated β coefficients (or odds ratios) and 95% confidence intervals (CIs) and tested interactions with age, sex, and race/ethnicity.
On average at baseline, participants were aged 64 years and had 10 years of education; 60% were women and 66% were Caribbean Hispanic. The mean (SD) time lag between baseline and MRI was 6 (3) years. Greater BMI and WC were significantly associated with thinner cortices (BMI β [95% CI] -0.089 [-0.153, -0.025], WC β [95% CI] -0.103 [-0.169, -0.037]) in fully adjusted models. Similarly, compared to those with BMI <25, obese participants (BMI ≥30) exhibited smaller cortical thickness (β [95% CI] -0.207 [-0.374, -0.041]). These associations were particularly evident for those aged <65 years. Similar but weaker associations were observed for TCV. Most associations with WMHV and SBI did not reach statistical significance.
Adiposity in early-old age is related to reduced global gray matter later in life in this diverse sample. Future studies are warranted to elucidate causal relationships and explore region-specific associations.
研究中年至老年早期肥胖指标与后期大脑老化的 MRI 标志物之间的关联。
我们分析了来自北方曼哈顿 MRI 子研究（n=1289）的数据。我们感兴趣的暴露因素包括体重指数（BMI）、腰围（WC）、腰臀比和血浆脂联素水平。我们感兴趣的结局包括总脑容量（TCV）、皮质厚度、脑白质高信号体积（WMHV）和亚临床脑梗死（SBI）。我们使用多变量线性和逻辑回归模型，调整了社会人口统计学、健康行为和血管危险因素，估计了β系数（或比值比）和 95%置信区间（CI），并检验了年龄、性别和种族/民族的交互作用。
平均而言，参与者在基线时年龄为 64 岁，受教育年限为 10 年；60%为女性，66%为加勒比西班牙裔。从基线到 MRI 的平均（SD）时间滞后为 6（3）年。在完全调整的模型中，较高的 BMI 和 WC 与皮质变薄显著相关（BMI β[95%CI]-0.089[-0.153，-0.025]，WC β[95%CI]-0.103[-0.169，-0.037]）。同样，与 BMI<25 的人相比，肥胖参与者（BMI≥30）的皮质厚度较小（β[95%CI]-0.207[-0.374，-0.041]）。这些关联在年龄<65 岁的人群中尤为明显。对于 TCV，也观察到了类似但较弱的关联。与 WMHV 和 SBI 的大多数关联没有达到统计学意义。
在这个多样化的样本中，中年早期的肥胖与后期生活中总灰质减少有关。需要进一步的研究来阐明因果关系，并探索特定区域的关联。
