Hypertensive Aspects of Cardiometabolic Disorders Are Associated with Lower Brain Microstructure, Perfusion, and Cognition.
Hypertensive Aspects of Cardiometabolic Disorders Are Associated with Lower Brain Microstructure, Perfusion, and Cognition.
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心脏代谢性疾病的高血压方面与较低的大脑微观结构，灌注和认知有关。
DOI：
10.3233/jad-220646
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发表时间：
2022
影响因子：
4
通讯作者：
Craft, Suzanne
中科院分区：
文献类型：
--
作者：
Hughes, Timothy M.;Lockhart, Samuel N.;Suerken, Cynthia K.;Jung, Youngkyoo;Whitlow, Christopher T.;Bateman, James R.;Williams, Benjamin J.;Espeland, Mark A.;Sachs, Bonnie C.;Williamson, Jeff;Cleveland, Maryjo;Yang, Mia;Rogers, Samantha;Hayden, Kathleen M.;Baker, Laura D.;Craft, Suzanne
心脏代谢紊乱（高血压、糖尿病）是阿尔茨海默病和相关疾病的关键可变风险因素。它们经常同时发生;然而，它们独立影响大脑结构和功能的程度尚不清楚。我们假设在一个不同的老年人队列中，它们的联合作用与认知功能和白色物质（WM）健康和脑灌注的神经影像学生物标志物的相关性更大。年龄在50-85岁之间的参与者接受：临床评价、口服葡萄糖耐量试验、神经影像学、认知测试和裁定。神经影像学检查包括：T1（灰度[GM]/WM分割，区域体积/厚度）; FLAIR（WM高信号体积[WMHv]）;动脉自旋标记（脑血流）;扩散张量成像（分数各向异性[FA]）;以及神经突方向弥散和密度成像（游离水）。对高血压（HTN）和糖耐量受损（IGT）进行分期，并对心脏代谢状态进行分类（仅HTN、仅IGT、IGT+HTN、两者均不）。多变量线性回归模型与认知和神经影像学指标（协变量：年龄，性别，种族）的关联。MRI可用于478名参与者（35%轻度认知障碍，10%痴呆），平均年龄70±8岁，74% HTN，61% IGT，15%自认为是黑人/非裔美国人。IGT+HTN与认知功能障碍、较高的WM游离水和WMHv、较低的FA和较低的GM灌注显著相关，而与两个因素均无相关性。HTN单独与较差的认知和较低的GM灌注相关。心脏代谢因素与GM宏观结构（体积，颞叶皮质厚度）或认知状态无关。HTN及其与IGT（HTN+IGT）的共同发生与较低的整体认知能力，减少GM灌注和受损的WM微观结构。
Cardiometabolic disorders (hypertension, diabetes) are key modifiable risk factors for Alzheimer’s disease and related disorders. They often co-occur; yet, the extent to which they independently affect brain structure and function is unclear. We hypothesized their combined effect is greater in associations with cognitive function and neuroimaging biomarkers of white matter (WM) health and cerebral perfusion in a diverse older adult cohort. Participants aged 50–85 years received: clinical evaluation, oral glucose tolerance testing, neuroimaging, cognitive testing, and adjudication. Neuroimaging included: T1 (gray [GM]/WM segmentation, regional volumes/thicknesses); FLAIR (WM hyperintensity volume [WMHv]; arterial spin labelling (cerebral blood flow); diffusion tensor imaging (fractional anisotropy [FA]); and neurite orientation dispersion and density imaging (Free Water). Hypertension (HTN) and impaired glucose tolerance (IGT) were staged and cardiometabolic status was categorized (HTN only, IGT only, IGT+HTN, neither). Multivariable linear regression modeled associations with cognitive and neuroimaging measures (covariates: age, gender, race). MRI was available for 478 participants (35% mild cognitive impairment, 10% dementia) with mean age 70±8 years, 74% with HTN, 61% with IGT, and 15% self-identified as Black/African-American. IGT+HTN was significantly associated with cognitive impairment, higher WM Free Water and WMHv, lower FA, and lower GM perfusion compared to neither factor. HTN alone was associated with poorer cognition and lower GM perfusion. Cardiometabolic factors were not associated with GM macrostructure (volumes, temporal lobe cortical thickness) or cognitive status. HTN and its co-occurrence with IGT (HTN+IGT) were associated with lower global cognitive performance and reduced GM perfusion and impaired WM microstructure.