性别特异性的心血管代谢综合征与皮质厚度降低的关系。
Sex-specific relationship of cardiometabolic syndrome with lower cortical thickness.
机构信息
From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
出版信息
Neurology. 2019 Sep 10;93(11):e1045-e1057. doi: 10.1212/WNL.0000000000008084. Epub 2019 Aug 23.
OBJECTIVE
To investigate whether cardiometabolic factors were associated with age-related differences in cortical thickness in relation to sex.
METHODS
In this cross-sectional study, we enrolled 1,322 cognitively normal elderly (≥65 years old) individuals (774 [58.5%] men, 548 [41.5%] women). We measured cortical thickness using a surface-based analysis. We analyzed the associations of cardiometabolic risk factors with cortical thickness using multivariate linear regression models after adjusting for possible confounders and interactions with age.
RESULT
Among women, hypertension (β = -1.119 to -0.024, < 0.05) and diabetes mellitus (β = -0.920, = 0.03) were independently associated with lower mean cortical thickness. In addition, there was an interaction effect between obesity (body mass index [BMI] ≥27.5 kg/m) and age on cortical thickness in women (β = -0.324 to -0.010, < 0.05), suggesting that age-related differences in cortical thickness were more prominent in obese women compared to women with normal weight. Moreover, low education level (<6 years) was correlated with lower mean cortical thickness (β = -0.053 to -0.046, < 0.05). Conversely, among men, only being underweight (BMI ≤18.5 kg/m, β = -2.656 to -0.073, < 0.05) was associated with lower cortical thickness.
CONCLUSIONS
Our findings suggest that cortical thickness is more vulnerable to cardiometabolic risk factors in women than in men. Therefore, sex-specific prevention strategies may be needed to protect against accelerated brain aging.
目的
探讨代谢相关因素是否与性别相关的皮质厚度的年龄相关差异有关。
方法
在这项横断面研究中，我们纳入了 1322 名认知正常的老年人（≥65 岁）（774 名男性[58.5%]，548 名女性[41.5%]）。我们使用基于表面的分析来测量皮质厚度。在调整了可能的混杂因素和与年龄的相互作用后，我们使用多元线性回归模型来分析代谢相关危险因素与皮质厚度之间的关系。
结果
在女性中，高血压（β=-1.119 至-0.024， <0.05）和糖尿病（β=-0.920， =0.03）与皮质厚度的平均值降低独立相关。此外，肥胖（体重指数[BMI]≥27.5kg/m）和年龄对女性皮质厚度之间存在交互作用（β=-0.324 至-0.010， <0.05），表明肥胖女性与正常体重女性相比，皮质厚度的年龄相关差异更为明显。此外，低教育水平（<6 年）与皮质厚度的平均值降低相关（β=-0.053 至-0.046， <0.05）。相反，在男性中，只有体重过轻（BMI≤18.5kg/m，β=-2.656 至-0.073， <0.05）与皮质厚度降低相关。
结论
我们的研究结果表明，皮质厚度在女性中比男性更容易受到代谢相关危险因素的影响。因此，可能需要针对特定性别的预防策略来保护大脑免受加速衰老的影响。
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