Associations of Brain Structure With Adiposity and Changes in Adiposity in a Middle-Aged and Older Biracial Population

作者：Windham B Gwen^*; Lirette Seth T; Fornage Myriam; Benjamin Emelia J; Parker Kirby G; Turner Stephen T; Jack Clifford R Jr; Griswold Michael E; Mosley Thomas H

来源：Journals of Gerontology Series A-Biological Sciences and Medical Sciences, 2017, 72(6): 825-831.

DOI：10.1093/gerona/glw239

• Obesity
• MRI
• Race
• Longitudinal

Background: Studies of adiposity and brain pathology in African Americans (AA) are sparse despite higher rates of obesity, dementia, and dementia-associated brain pathology in AA. This study examined relations of adiposity to white matter hyperintensities (WMH) and total brain volume (TBV) in AA and non-Hispanic whites (NHW).
Methods: Waist circumference (WC) and body mass index (BMI) were measured in the Genetic Epidemiology Network of Arteriopathy study at Visits 1 (mean age 57 [+/- 11]) and 2 (mean age 61 [+/- 10], mean 5.2 years later). Brain MRIs were obtained shortly after Visit 2 in 1,702 participants (64% women, 48% AA). Multilevel linear regression using generalized estimating equation estimated associations of adiposity (cross-sectional) or adiposity changes with WMH (accounting for intracranial size) or TBV adjusting for demographics, cardiovascular risk factors, and incorporating adiposity-by-race interactions. Adiposity-by-age interactions were examined.
Results: Concurrent TBV was inversely associated with BMI (beta = -2.76 [95% confidence interval (CI): -4.99, -0.53]) and WC (beta = -2.19 [CI: -4.04, -0.34]). Concurrent WMH were negatively associated with BMI (beta = -0.04 [CI: -0.06, -0.01]) and, among NHW, with WC (beta = -0.04 [CI: -0.06, -0.02]) but not with changes in BMI or WC. BMI increases were associated with lower TBV (beta = -16.20, [CI: -30.34, -2.06]) in AA but not in NHW (beta = -2.76 [CI: -14.02, 8.51]), although race-by-adiposity interactions were not supported. WC increases were not associated with MRI outcomes.
Conclusion: Greater measures of obesity and increases in measures of obesity, which are common in mid-life, could be detrimental to brain health, particularly in AA.

• 出版日期2017-6