Red Cell Distribution Width, Anemia, and Brain Volumetric Outcomes Among Middle-Aged Adults.
Red Cell Distribution Width, Anemia, and Brain Volumetric Outcomes Among Middle-Aged Adults.
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DOI：
10.3233/jad-201386
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发表时间：
2021
影响因子：
4
通讯作者：
Waldstein, Shari R.
中科院分区：
文献类型：
--
作者：
Beydoun, May A.;Hossain, Sharmin;MacIver, Peter H.;Srinivasan, Dhivya;Beydoun, Hind A.;Maldonado, Ana, I;Katzel, Leslie, I;Davatzikos, Christos;Gullapalli, Rao P.;Seliger, Stephen L.;Erus, Guray;Evans, Michele K.;Zonderman, Alan B.;Waldstein, Shari R.
贫血和红细胞分布宽度（RDW）与认知能力差有关，其潜在机制有待研究。我们检查了5-6年后初始RDW状态（v1）、RDW变化（δ）和贫血与脑结构磁共振成像（sMRI）标记物（包括全脑和皮质脑以及海马和白色病变（WML）体积）的横断面关系。使用了来自生命周期中多样性社区健康老龄化（HANDLS）研究中的三次前瞻性访视的数据，包括完整的v1（2004-2009）和v2（2009-2013）暴露以及vscan时的辅助sMRI数据（2011-2015，n = 213，平均v1至vscan时间：5.7年）。总体上，按性别、人种和非贫血患者进行了多变量校正线性回归模型，用q值校正了多重检验。在最小调整模型（社会人口统计学和随访时间）中，贫血1和RDWv 1始终与总体上较小的双侧海马体积相关，并且在女性中（q<0.05），没有显著的性别差异。在血液学测量校正模型中，RDWv 1与较小的选择区域皮质脑灰质和白色物质体积相关;贫血1仅在白人中与较大的WML体积相关。总之，基线贫血和RDW始终与较小的双侧海马体积相关，特别是在女性中，而贫血与白人中较大的WML体积相关。在血液学测量校正模型中，基线RDW与较小的区域灰色和白色物质体积相关。需要进行sMRI重复研究的随机对照试验，以证明贫血和RDW升高与脑容量减少和认知功能障碍的相关性。
Anemia and red cell distribution width (RDW) have been linked to poor cognitive performance, pending studies of underlying mechanisms. We examined cross-sectional relationships of initial RDW status (v1), RDW change (δ), and anemia with brain structural magnetic resonance imaging (sMRI) markers, including global and cortical brain and hippocampal and white matter lesion (WML) volumes, 5–6 years later. Data were used from three prospective visits within the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study with complete v1 (2004–2009) and v2 (2009–2013) exposures and ancillary sMRI data at vscan (2011–2015, n = 213, mean v1 to vscan time: 5.7 years). Multivariable-adjusted linear regression models were conducted, overall, by sex, by race, and within non-anemics, correcting for multiple testing with q-values. In minimally adjusted models (socio-demographics and follow-up time), anemiav1 and RDWv1 were consistently associated with smaller bilateral hippocampal volumes overall, and among females (q<0.05), without significant sex differences. RDWv1 was related to smaller select regional cortical brain gray and white matter volumes in hematological measure-adjusted models; anemiav1 was associated with larger WML volumes only among whites. In summary, baseline anemia and RDW were consistently associated with smaller bilateral hippocampal volumes, particularly among females, while anemia was linked to larger WML volume among Whites. In hematological measure-adjusted models, baseline RDW was linked to smaller regional gray and white matter volumes. Pending studies with sMRI repeats, randomized controlled trials are needed, demonstrating associations of anemia and elevated RDW with reduced brain volumes and cognitive dysfunction.