Jung Joon Hyung, Lee Ga Won, Lee Jun Ho, Byun Min Soo, Yi Dahyun, Jeon So Yeon, Jung Gi Jung, Joung Haejung, Shin Seong A, Kim Yu Kyeong, Kang Koung Mi, Sohn Chul-Ho, Lee Dong Young
Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.
Front Aging Neurosci. 2020 Jun 3;12:159. doi: 10.3389/fnagi.2020.00159. eCollection 2020.
Multiparity - grand multiparity (i.e., five or more childbirths) in particular - has been reported to have an association with increased risk of Alzheimer's disease (AD) dementia or related cognitive decline in women. However, the pathological links underlying this relationship are still unknown. This study was conducted to examine the relationships of multiparity with cerebral amyloid-beta (Aβ) deposition, brain atrophy, and white matter hyperintensities (WMHs).
In this study, total of 237 older women with 148 cognitively normal and 89 mild cognitive impairment from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease (KBASE) were included. Participants underwent clinical and neuropsychological assessments in addition to C-labeled Pittsburgh Compound B positron emission tomography, and magnetic resonance imaging. The associations of parity with Aβ deposition, hippocampal volume, cortical volume, WMH volume and mini-mental status examination (MMSE) score were examined.
Participants with grand multiparity showed significantly reduced adjusted hippocampal volume, spatial pattern of atrophy for recognition of AD volume and spatial pattern of atrophy for recognition of brain aging volume even after controlling for potential confounders. Furthermore, MMSE score was also significantly lower in this group. In contrast, grand multiparity did not show any association with global Aβ retention, Aβ positivity rate, or WMH volume, regardless of covariates.
Our findings suggest that grand multiparity contributes to cognitive decline or increased dementia risk in older women by aggravating amyloid-independent hippocampal or cortical atrophy.
据报道，多产尤其是经产妇（即分娩五次或更多次）与女性患阿尔茨海默病（AD）痴呆症或相关认知衰退的风险增加有关。然而，这种关系背后的病理联系仍然未知。本研究旨在探讨多产与脑淀粉样β蛋白（Aβ）沉积、脑萎缩和白质高信号（WMH）之间的关系。
本研究纳入了来自韩国阿尔茨海默病早期诊断和预测脑老化研究（KBASE）的237名老年女性，其中148名认知正常，89名轻度认知障碍。参与者除了接受11C标记的匹兹堡化合物B正电子发射断层扫描和磁共振成像外，还接受了临床和神经心理学评估。研究了产次与Aβ沉积、海马体积、皮质体积、WMH体积和简易精神状态检查表（MMSE）评分之间的关联。
即使在控制了潜在的混杂因素后，经产妇的调整后海马体积、用于识别AD体积的萎缩空间模式和用于识别脑老化体积的萎缩空间模式仍显著减小。此外，该组的MMSE评分也显著较低。相比之下，无论协变量如何，经产妇与整体Aβ潴留、Aβ阳性率或WMH体积均无关联。
我们的研究结果表明，经产妇通过加重不依赖淀粉样蛋白的海马或皮质萎缩，导致老年女性认知衰退或痴呆风险增加。
