From the Departments of Anatomy (I.A.C.A., A.J.K.) and Neurology (E.M.C.L., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, and Radboud Alzheimer Center (I.A.C.A., A.J.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Neurology (D.R.G.), The State University of New York Downstate Health Sciences University, Brooklyn; and Department of Health and Education (D.R.G.), University of Skövde, Sweden.
Neurology. 2019 Aug 27;93(9):e864-e878. doi: 10.1212/WNL.0000000000008002. Epub 2019 Jul 30.
Adiposity predictors, body mass index (BMI), waist circumference (WC), and blood leptin and total adiponectin levels were associated with components of cerebral small vessel disease (CSVD) and brain volumetry in 503 adults with CSVD who were ≥50 years of age and enrolled in the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Imaging Cohort (RUN DMC).
RUN DMC participants were followed up for 9 years (2006-2015). BMI, WC, brain imaging, and dementia diagnoses were evaluated at baseline and follow-up. Adipokines were measured at baseline. Brain imaging outcomes included CSVD components, white matter hyperintensities, lacunes, microbleeds, gray and white matter, hippocampal, total brain, and intracranial volumes.
Cross-sectionally among men at baseline, higher BMI, WC, and leptin were associated with lower gray matter and total brain volumes, and higher BMI and WC were associated with lower hippocampal volume. At follow-up 9 years later, higher BMI was cross-sectionally associated with lower gray matter volume, and an obese WC (>102 cm) was protective for ≥1 lacune or ≥1 microbleed in men. In women, increasing BMI and overweight or obesity (BMI ≥25 kg/m or WC >88 cm) were associated with ≥1 lacune. Longitudinally, over 9 years, a baseline obese WC was associated with decreasing hippocampal volume, particularly in men, and increasing white matter hyperintensity volume in women and men.
Anthropometric and metabolic adiposity predictors were differentially associated with CSVD components and brain volumetry outcomes by sex. Higher adiposity is associated with a vascular-neurodegenerative spectrum among adults at risk for vascular forms of cognitive impairment and dementias.
肥胖预测因子、体重指数（BMI）、腰围（WC）以及血液瘦素和总脂联素水平与 503 名≥50 岁且患有脑小血管病（CSVD）的成年人的 CSVD 成分和脑容积有关，这些成年人参加了拉德堡德大学尼美根弥散张量和磁共振成像队列（RUN DMC）。
RUN DMC 参与者接受了 9 年的随访（2006-2015 年）。在基线和随访时评估 BMI、WC、脑成像和痴呆诊断。在基线时测量脂联素。脑成像结果包括 CSVD 成分、白质高信号、腔隙、微出血、灰质和白质、海马体、总脑和颅内体积。
在基线时，男性的横断面研究中，较高的 BMI、WC 和瘦素与较低的灰质和总脑体积相关，较高的 BMI 和 WC 与较低的海马体体积相关。9 年后的随访中，较高的 BMI 与较低的灰质体积呈横断面相关，而肥胖的 WC（>102cm）对男性的≥1 个腔隙或≥1 个微出血有保护作用。在女性中，BMI 和超重或肥胖（BMI≥25kg/m 或 WC>88cm）与≥1 个腔隙相关。纵向来看，9 年内，基线时肥胖的 WC 与海马体体积的减少相关，尤其是在男性中，并且与女性和男性的白质高信号体积增加相关。
人体测量学和代谢肥胖预测因子与 CSVD 成分和脑容积结果按性别存在差异相关。较高的肥胖与血管性认知障碍和痴呆血管形式风险成年人的血管-神经退行性谱相关。
