King Kevin S, Vintimilla Raul M, Braskie Meredith N, Wei Ke, Hall James R, Borzage Matt, Johnson Leigh A, Yaffe Kristine, Toga Arthur W, O'Bryant Sid E
Department of Neuroradiology Barrow Neurological Institute Phoenix Arizona USA.
Institute for Translational Research University of North Texas Health Science Center Fort Worth Texas USA.
Alzheimers Dement (Amst). 2022 Feb 23;14(1):e12263. doi: 10.1002/dad2.12263. eCollection 2022.
Among vascular risk factors we hypothesized that an increased prevalence of diabetes in Hispanics would be associated with greater white matter hyperintensity (WMH) volume, which may contribute to cognitive decline.
A total of 1318 participants (60% female; 49% Hispanic, 51% non-Hispanic White; age 66.2 ± 8.9 years) underwent clinical evaluation and brain magnetic resonance imaging (MRI). WMH volume associations were assessed with age, sex, and ethnicity and then with vascular risk factors in a selective regression model.
WMH volume was greater with older age ( < .0001), Hispanic ethnicity ( = .02), and female sex ( = .049). WMH volume was best predicted by age, diastolic blood pressure, hypertension history, hemoglobin A1c (HbA1c), white blood cell count, and hematocrit ( < .01 for all). Elevated HbA1c was associated with greater WMH volume among Hispanics (parameter estimate 0.08 ± 0.02, < .0001) but not non-Hispanic Whites (parameter estimate 0.02 ± 0.04, = .5).
WMH volume was greater in Hispanics, which may be partly explained by increased WMH volume related to elevated HbA1c among Hispanics but not non-Hispanic Whites.
在血管危险因素中，我们假设西班牙裔人群中糖尿病患病率的增加与更大的脑白质高信号（WMH）体积相关，这可能导致认知能力下降。
共有1318名参与者（60%为女性；49%为西班牙裔，51%为非西班牙裔白人；年龄66.2±8.9岁）接受了临床评估和脑部磁共振成像（MRI）检查。在一个选择性回归模型中，评估WMH体积与年龄、性别和种族的关联，然后评估与血管危险因素的关联。
WMH体积在年龄较大者（<0.0001）、西班牙裔种族（=0.02）和女性（=0.049）中更大。年龄、舒张压、高血压病史、糖化血红蛋白（HbA1c）、白细胞计数和血细胞比容对WMH体积的预测效果最佳（所有P<0.01）。HbA1c升高在西班牙裔人群中与更大的WMH体积相关（参数估计值0.08±0.02，<0.0001），但在非西班牙裔白人中则不然（参数估计值0.02±0.04，=0.5）。
西班牙裔人群的WMH体积更大，这可能部分归因于西班牙裔人群中与HbA1c升高相关的WMH体积增加，而非西班牙裔白人则不然。
