Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.
Eur J Neurol. 2022 Sep;29(9):2612-2621. doi: 10.1111/ene.15416. Epub 2022 Jun 9.
Little is known about whether nonalcoholic fatty liver disease (NAFLD) is associated with dementia or the role of serum proinflammatory cytokines in the association. We aimed to investigate the interrelationships of NAFLD, serum cytokines, and dementia among rural-dwelling older adults.
This population-based cross-sectional study included 5129 participants (aged ≥60 years; 61.79% women) who were living in rural communities and examined in March 2018-September 2018. NAFLD was defined through transabdominal ultrasound examination in the absence of hepatitis B or excessive alcohol consumption. Serum cytokines were measured in a subsample (n = 1686). Dementia, Alzheimer disease (AD), and vascular dementia (VaD) were diagnosed following international criteria. Data were analyzed with logistic regression and mediation models.
Of the 5129 participants, 455 (8.87%) were detected with moderate-to-severe NAFLD, and 292 (5.69%) were diagnosed with dementia (188 with AD and 96 with VaD). The multivariable adjusted odds ratios associated with moderate-to-severe (vs. no-to-mild) NAFLD were 2.22 (95% confidence interval [CI] = 1.41-3.49) for all-cause dementia, 1.88 (95% CI = 1.01-3.50) for AD, and 2.62 (95% CI = 1.33-5.17) for VaD. In the cytokine subsample, controlling for multiple potential confounders, moderate-to-severe NAFLD was significantly associated with higher levels of serum monocyte chemotactic protein-1, interleukin-17A, interleukin-6 (IL-6), interleukin-8, and tumor necrosis factor-α (P < 0.05). The mediation analysis showed that IL-6 mediated 12.56% of the association between NAFLD and VaD.
Moderate-to-severe nonalcoholic fatty liver disease is associated with dementia and AD, especially with VaD, among rural-dwelling Chinese older adults, in which the association with VaD is partly mediated by serum inflammatory cytokines.
非酒精性脂肪性肝病（NAFLD）是否与痴呆有关，以及血清促炎细胞因子在其中的作用尚不清楚。我们旨在研究农村老年人中 NAFLD、血清细胞因子和痴呆之间的相互关系。
本研究为基于人群的横断面研究，纳入了 5129 名（年龄≥60 岁；61.79%为女性）居住在农村社区的参与者，并于 2018 年 3 月至 9 月进行了检查。NAFLD 通过腹部超声检查在无乙型肝炎或过量饮酒的情况下进行定义。在亚样本（n=1686）中测量了血清细胞因子。根据国际标准诊断痴呆、阿尔茨海默病（AD）和血管性痴呆（VaD）。使用逻辑回归和中介模型进行数据分析。
在 5129 名参与者中，455 名（8.87%）被检测到存在中重度 NAFLD，292 名（5.69%）被诊断为痴呆（188 名 AD 和 96 名 VaD）。与无至轻度（vs. 无至轻度）NAFLD 相比，中重度（vs. 无至轻度）NAFLD 的多变量调整比值比分别为全因痴呆 2.22（95%置信区间[CI]：1.41-3.49）、AD 1.88（95%CI：1.01-3.50）和 VaD 2.62（95%CI：1.33-5.17）。在细胞因子亚样本中，控制多个潜在混杂因素后，中重度 NAFLD 与血清单核细胞趋化蛋白-1、白细胞介素-17A、白细胞介素-6（IL-6）、白细胞介素-8 和肿瘤坏死因子-α水平升高显著相关（P<0.05）。中介分析表明，IL-6 介导了 NAFLD 与 VaD 之间 12.56%的关联。
在农村中国老年人中，中重度非酒精性脂肪性肝病与痴呆和 AD 相关，尤其是与 VaD 相关，其中与 VaD 的相关性部分由血清炎症细胞因子介导。
