Hayes Cellas A, Jones Raymond, Thorpe Roland J
Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA.
Department of Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA.
J Alzheimers Dis. 2025 Aug 4:13872877251365128. doi: 10.1177/13872877251365128.
Cardiometabolic conditions accelerate white-matter hyperintensity (WMH) accumulation-a vascular injury marker linked to increased Alzheimer's disease risk-yet how these relationships vary by race and ethnicity in males is poorly understood. To quantify racial ethnic-specific associations between cardiometabolic risk factors, blood-pressure indices, and WMH volume in Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Hispanic males. We analyzed 1378 males (558 NHW, 375 NHB, 445 Hispanic) from the Healthy Aging Brain Study-Health Disparities. Five binary exposures (hypertension, diabetes, dyslipidemia, obesity, tobacco dependence), four continuous blood-pressure metrics (systolic, diastolic, pulse, mean arterial pressure), and a principal-component cardiometabolic score were regressed on log-transformed, intracranial volume-adjusted WMH volume in race-stratified models. Hispanic males exhibited the broadest vulnerability: hypertension, diabetes, and tobacco dependence each predicted higher WMH (β range 0.60-0.77, ≤ 0.002), and the composite score had the strongest association (β = 0.26, 0.13-0.39, < 0.001). Additionally, every 10-mm Hg rise in systolic, diastolic, pulse, or mean arterial pressure further increased WMH in Hispanic males (e.g., systolic β = 0.18, 0.11-0.26), an effect absent in NHW and NHB males. Cardiometabolic and hemodynamic drivers of WMH differ markedly across racial and ethnic groups of males, with Hispanic males showing the most pervasive risk profile, NHB males selective associations, and NHW males limited links. Tailored vascular-risk interventions may be essential to curb WMH-related pathways to Alzheimer's disease in racially and ethnically diverse male populations.
心脏代谢疾病会加速白质高信号（WMH）的积累——这是一种与阿尔茨海默病风险增加相关的血管损伤标志物——然而，这些关系在男性中如何因种族和族裔而异却知之甚少。为了量化非西班牙裔白人（NHW）、非西班牙裔黑人（NHB）和西班牙裔男性中心脏代谢风险因素、血压指标与WMH体积之间的种族和族裔特异性关联。我们分析了来自健康衰老大脑研究——健康差异项目的1378名男性（558名NHW、375名NHB、445名西班牙裔）。在种族分层模型中，将五种二元暴露因素（高血压、糖尿病、血脂异常、肥胖、烟草依赖）、四种连续血压指标（收缩压、舒张压、脉压、平均动脉压）以及一个主成分心脏代谢评分与经对数转换、颅内体积校正后的WMH体积进行回归分析。西班牙裔男性表现出最广泛的易感性：高血压、糖尿病和烟草依赖各自都预示着更高的WMH（β范围为0.60 - 0.77，P≤0.002），并且综合评分的关联最强（β = 0.26，0.13 - 0.39，P < 0.001）。此外，收缩压、舒张压、脉压或平均动脉压每升高10毫米汞柱，西班牙裔男性的WMH会进一步增加（例如，收缩压β = 0.18，0.11 - 0.26），而NHW和NHB男性中不存在这种效应。男性不同种族和族裔群体中WMH的心脏代谢和血流动力学驱动因素存在显著差异，西班牙裔男性的风险特征最为普遍全，NHB男性有选择性关联，NHW男性的联系有限。针对血管风险的干预措施可能对于遏制不同种族和族裔男性群体中与WMH相关的阿尔茨海默病发病途径至关重要。
