Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom.
Institute for Infection and Immunity, St George's University of London, London, United Kingdom.
PLoS One. 2021 Nov 5;16(11):e0259375. doi: 10.1371/journal.pone.0259375. eCollection 2021.
Changes in brain structure and cognitive decline occur in Chronic Obstructive Pulmonary Disease (COPD). They also occur with smoking and coronary artery disease (CAD), but it is unclear whether a common mechanism is responsible.
Brain MRI markers of brain structure were tested for association with disease markers in other organs. Where possible, principal component analysis (PCA) was used to group markers within organ systems into composite markers. Univariate relationships between brain structure and the disease markers were explored using hierarchical regression and then entered into multivariable regression models.
100 participants were studied (53 COPD, 47 CAD). PCA identified two brain components: brain tissue volumes and white matter microstructure, and six components from other organ systems: respiratory function, plasma lipids, blood pressure, glucose dysregulation, retinal vessel calibre and retinal vessel tortuosity. Several markers could not be grouped into components and were analysed as single variables, these included brain white matter hyperintense lesion (WMH) volume. Multivariable regression models showed that less well organised white matter microstructure was associated with lower respiratory function (p = 0.028); WMH volume was associated with higher blood pressure (p = 0.036) and higher C-Reactive Protein (p = 0.011) and lower brain tissue volume was associated with lower cerebral blood flow (p<0.001) and higher blood pressure (p = 0.001). Smoking history was not an independent correlate of any brain marker.
Measures of brain structure were associated with a range of markers of disease, some of which appeared to be common to both COPD and CAD. No single common pathway was identified, but the findings suggest that brain changes associated with smoking-related diseases may be due to vascular, respiratory, and inflammatory changes.
慢性阻塞性肺疾病（COPD）患者的大脑结构会发生变化，认知能力也会下降。吸烟和冠状动脉疾病（CAD）也会出现这种情况，但目前尚不清楚是否存在共同的发病机制。
研究人员测试了大脑 MRI 标志物与其他器官疾病标志物之间的相关性。在可能的情况下，使用主成分分析（PCA）将器官系统内的标志物组合成综合标志物。使用分层回归法探讨大脑结构与疾病标志物之间的单变量关系，然后将其纳入多变量回归模型。
共纳入 100 名参与者（COPD 患者 53 名，CAD 患者 47 名）。PCA 确定了两个大脑成分：脑组织体积和大脑白质微观结构，以及六个来自其他器官系统的成分：呼吸功能、血浆脂质、血压、血糖失调、视网膜血管直径和视网膜血管迂曲度。一些标志物无法分组成成分，因此作为单个变量进行分析，其中包括脑白质高信号病变（WMH）体积。多变量回归模型显示，白质微观结构组织越不规整，呼吸功能越差（p = 0.028）；WMH 体积与血压升高（p = 0.036）和 C 反应蛋白升高（p = 0.011）相关，而脑组织体积与大脑血流减少（p<0.001）和血压升高（p = 0.001）相关。吸烟史并不是任何大脑标志物的独立相关因素。
大脑结构的测量值与一系列疾病标志物相关，其中一些标志物似乎在 COPD 和 CAD 中都存在。没有发现单一的共同发病途径，但研究结果表明，与吸烟相关的疾病相关的大脑变化可能是由于血管、呼吸和炎症变化引起的。
