Fu Yan, Sun Yan, Wang Zhi-Bo, Zhang Dan-Dan, Tan Lan, Feng Jian-Feng, Cheng Wei, Yu Jin-Tai
Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
Eur J Neurol. 2023 May;30(5):1200-1208. doi: 10.1111/ene.15750. Epub 2023 Mar 2.
The American Heart Association Life's Simple 7 (LS7) metric was used to define optimal cardiovascular and brain health, but the associations with macrostructural hyperintensities and microstructural white matter damage are unclear. The objective was to determine the association of LS7 ideal cardiovascular health factors with macrostructural and microstructural integrity.
A total of 37,140 participants with available LS7 and imaging data from UK Biobank were included in this study. Linear associations were implemented to examine the associations of LS7 score and subscores with white matter hyperintensity load (WMH) (WMH volume normalized by total white matter volume and logit-transformed) and diffusion imaging indices (fractional anisotropy [FA], mean diffusivity, orientation dispersion index [OD], intracellular volume fraction, isotropic volume fraction [ISOVF]).
In individuals (mean age 54.76 years; 19,697 females, 52.4%), higher LS7 score and subscores were strongly associated with lower WMH and microstructural white matter injury, including OD, ISOVF, FA. Both interaction analyses and stratified analyses of LS7 score and subscores with age and sex showed a strong association with microstructural damage markers, with remarkable age and sex differences. The association of OD was pronounced in females and populations younger than 50 years and FA, mean diffusivity and ISOVF were pronounced in males and populations older than 50 years.
These findings suggest that healthier LS7 profiles are associated with better profiles of both macrostructural and microstructural markers of brain health, and indicate that ideal cardiovascular health is associated with improved brain health.
美国心脏协会的“生命简单7要素”（LS7）指标用于定义最佳心血管和脑健康状况，但该指标与宏观结构高强度及微观结构白质损伤之间的关联尚不清楚。本研究的目的是确定LS7理想心血管健康因素与宏观和微观结构完整性之间的关联。
本研究纳入了英国生物银行中共有37140名有可用LS7和成像数据的参与者。采用线性关联分析来研究LS7评分及各子评分与白质高信号负荷（WMH）（WMH体积通过总白质体积标准化并进行对数转换）和扩散成像指标（分数各向异性[FA]、平均扩散率、方向离散指数[OD]、细胞内体积分数、各向同性体积分数[ISOVF]）之间的关联。
在这些个体（平均年龄54.76岁；女性19697名，占52.4%）中，较高的LS7评分及各子评分与较低的WMH及微观结构白质损伤（包括OD、ISOVF、FA）密切相关。对LS7评分及各子评分与年龄和性别的交互分析和分层分析均显示与微观结构损伤标志物有很强的关联，且存在显著的年龄和性别差异。OD的关联在女性和50岁以下人群中较为明显，而FA、平均扩散率和ISOVF的关联在男性和50岁以上人群中较为明显。
这些研究结果表明，更健康的LS7特征与更好的脑健康宏观和微观结构标志物特征相关联，表明理想的心血管健康与改善脑健康相关。
