中年女性的颈动脉内膜中层厚度与脑白质高信号体积。
Carotid intima media thickness and white matter hyperintensity volume among midlife women.
机构信息
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
出版信息
Alzheimers Dement. 2023 Jul;19(7):3129-3137. doi: 10.1002/alz.12951. Epub 2023 Feb 1.
INTRODUCTION
Carotid atherosclerosis may be associated with brain white matter hyperintensities (WMH). Few studies consider women at midlife, a critical time for women's cardiovascular and brain health. We tested the hypothesis that higher carotid intima media thickness (IMT) would be associated with greater WMH volume (WMHV) among midlife women. We explored interactions by apolipoprotein E (APOE) ε4 status.
METHODS
Two hundred thirty-nine women aged 45 to 67 underwent carotid artery ultrasound, phlebotomy, and magnetic resonance imaging (MRI). One hundred seventy participants had undergone an ultrasound 5 years earlier.
RESULTS
Higher IMT was associated with greater whole brain (B[standard error (SE)] = 0.77 [.31], P = 0.01; multivariable) and periventricular (B[SE] = 0.80 [.30], P = 0.008; multivariable) WMHV. Associations were observed for IMT assessed contemporaneously with the MRI and 5 years prior to the MRI. Associations were strongest for APOE ε4-positive women.
DISCUSSION
Among midlife women, higher IMT was associated with greater WMHV. Vascular risk is critical to midlife brain health, particularly for APOE ε4-positive women.
简介
颈动脉粥样硬化可能与脑白质高信号（WMH）有关。很少有研究关注中年女性，这是女性心血管和大脑健康的关键时期。我们检验了这样一个假设，即颈动脉内膜中层厚度（IMT）较高的中年女性，其脑白质高信号体积（WMHV）也会更大。我们还通过载脂蛋白 E（APOE）ε4 状态来探讨了交互作用。
方法
239 名年龄在 45 至 67 岁的女性接受了颈动脉超声、静脉采血和磁共振成像（MRI）检查。其中 170 名参与者在 5 年前接受过超声检查。
结果
较高的 IMT 与全脑（B[标准误差（SE）] = 0.77 [.31]，P = 0.01；多变量）和脑室周围（B[SE] = 0.80 [.30]，P = 0.008；多变量）WMHV 更大相关。在 MRI 检查的同时以及在 MRI 检查前 5 年评估的 IMT 均观察到了这种相关性。APOE ε4 阳性女性的相关性最强。
讨论
在中年女性中，较高的 IMT 与更大的 WMHV 相关。血管风险对中年期大脑健康至关重要，尤其是对于 APOE ε4 阳性女性。
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