■对体型波动与大脑健康之间的关系知之甚少。这项研究旨在检查体重指数(BMI)和腰臀比(WHR)的长期变异性与接近大脑健康的神经影像学指标之间的关系。
■这项队列研究从多中心招募了1114名25-83岁的参与者,中国以社区为基础的队列研究。我们在2006-2018年期间对参与者的BMI和WHR轨迹进行建模,并通过计算斜率来评估BMI和WHR变异性(变化的方向和速度)。应用广义线性模型来研究BMI和WHR变异性与脑组织体积MRI标记的相关性。白质微结构完整性,白质高强度(WMH),脑小血管病(CSVD)。
■随访期间体重的逐渐增加与较低的整体各向异性分数相关(β=-0.18,95%置信区间[CI]-0.34至-0.02),较高的平均扩散系数(β=0.15,95%CI0.01-0.30)和径向扩散系数(β=0.17,95%CI0.02-0.32)。体重减轻还与较低的脑室周围WMH负担(β=-0.26,95%CI-0.48至-0.03)和中度至重度基底神经节扩大血管周围间隙的风险较低有关(BG-EPVS,比值比[OR]=0.41,95%CI0.20-0.83)。在超重人群中,体重减轻与较小体积的WMH相关(β=-0.47,95%CI-0.79至-0.15),脑室周围WMH(β=-0.57,95%CI-0.88至-0.26),和深WMH(β=-0.36,95%CI-0.69至-0.03),以及CSVD的风险较低(OR=0.22,95%CI0.08-0.62),lucune(OR=0.12,95%CI0.01-0.91)和中重度BG-EPVS(OR=0.24,95%CI0.09-0.61)。在患有中心性肥胖的成年人中,WHR损失与较大的灰质体积呈正相关(β=0.50,95%CI0.11-0.89),海马体积(β=0.62,95%CI0.15-1.09),海马旁回体积(β=0.85,95%CI0.34-1.37)。性别分层和年龄分层分析揭示了与主要结果相似的发现,在中年和晚年的个体中显著呈现关联模式。
■BMI水平的长期稳定对于维持大脑健康至关重要。逐渐增加的体重与受损的白质微结构完整性有关。体重和WHR损失与改善一般脑健康相关。我们的结果有助于更好地理解肥胖指标变化与大脑健康之间的综合关联。
■这项研究得到了第国家自然科学基金项目62171297(韩吕)和61931013(王振昌),不。北京市自然科学基金(韩吕)7242267,和不。[2015]北京学者计划(王振昌)160人。
UNASSIGNED: The relationship between the fluctuation in body size and brain health is poorly understood. This study aimed to examine the associations of long-term variability in body mass index (BMI) and waist-to-hip ratio (WHR) with neuroimaging metrics that approximate brain health.
UNASSIGNED: This cohort study recruited 1114 participants aged 25-83 years from a multicenter, community-based cohort study in
China. We modeled the BMI and WHR trajectories of participants during 2006-2018 and assessed the BMI and WHR variability (direction and speed of change) by calculating the slope. Generalized linear models were applied to investigate the associations of BMI and WHR variability with MRI markers of brain tissue volume, white matter microstructural integrity, white matter hyperintensity (WMH), and cerebral small vessel disease (CSVD).
UNASSIGNED: Progressive weight gain during follow-up was associated with lower global fractional anisotropy (beta = -0.18, 95% confidence interval [CI] -0.34 to -0.02), higher mean diffusivity (beta = 0.15, 95% CI 0.01-0.30) and radial diffusivity (beta = 0.17, 95% CI 0.02-0.32). Weight loss was also associated with a lower burden of periventricular WMH (beta = -0.26, 95% CI -0.48 to -0.03) and a lower risk of moderate-to-severe basal ganglia enlarged perivascular spaces (BG-EPVS, odds ratio [OR] = 0.41, 95% CI 0.20-0.83). Among overweight populations, weight loss was linked with smaller volumes of WMH (beta = -0.47, 95% CI -0.79 to -0.15), periventricular WMH (beta = -0.57, 95% CI -0.88 to -0.26), and deep WMH (beta = -0.36, 95% CI -0.69 to -0.03), as well as lower risk of CSVD (OR = 0.22, 95% CI 0.08-0.62), lacune (OR = 0.12, 95% CI 0.01-0.91) and moderate-to-severe BG-EPVS (OR = 0.24, 95% CI 0.09-0.61). In adults with central obesity, WHR loss was positively associated with larger gray matter volume (beta = 0.50, 95% CI 0.11-0.89), hippocampus volume (beta = 0.62, 95% CI 0.15-1.09), and parahippocampal gyrus volume (beta = 0.85, 95% CI 0.34-1.37). The sex-stratification and age-stratification analyses revealed similar findings with the main results, with the pattern of associations significantly presented in the individuals at mid-life and late-life.
UNASSIGNED: Long-term stability of BMI level is essential for maintaining brain health. Progressive weight gain is associated with impaired white matter microstructural integrity. Weight and WHR losses are associated with improved general brain health. Our results contribute to a better understanding of the integrated associations between variations in obesity measures and brain health.
UNASSIGNED: This study was supported by grants No. 62171297 (Han Lv) and 61931013 (Zhenchang Wang) from the National Natural Science Foundation of
China, No. 7242267 from the Beijing Natural Science Foundation (Han Lv), and No. [2015] 160 from the Beijing Scholars Program (Zhenchang Wang).