Cardiovascular risk factors and cerebral atrophy in a middle-aged cohort.
BACKGROUND
Because cardiovascular (CV) risk factors have been associated with declines in cognitive functions and late life dementia, CV risk factors should also be associated with brain atrophy.


OBJECTIVE
To study the association of CV risk factors with ventricular size (VS) and sulcal size (SS) in the middle-aged and young-elderly Atherosclerosis Risk in Communities (ARIC) Study cohort.


METHODS
Cerebral MRI was performed on 1,812 individuals (aged 50 to 73 [mean 62.3] years, 60% women, 50% African American) with no history of stroke or TIA from the ARIC cohort at study sites in Forsyth County, NC, and Jackson, MS. Neuroradiologists rated VS and SS using a semiquantitative, 10-point scale by visual comparison with a standardized reference atlas. CV risk factors were assessed approximately 6 years prior to the MR scan. The authors performed multivariate analyses to assess the independent relationship between CV risk factors and the two measures of brain atrophy.


RESULTS
Logistic regression models controlling for age, sex, race, and alcohol use found that the association between diabetes and VS is as follows: OR = 1.63, 95% CI: 1.19 to 2.24; p = 0.003. Increasing levels of fasting blood glucose also showed an association with greater VS (OR = 1.07, 95% CI: 1.03 to 1.10; p = 0.001, for each 10 mg/dL of blood glucose). No other CV risk factors were associated with greater VS or SS.


CONCLUSIONS
In this middle-aged and young-elderly cohort, diabetes mellitus was associated with greater ventricular size. Mechanisms for deterioration of brain structural integrity may include microvascular, amyloidogenic, or other not-yet-defined effects of diabetes mellitus.
Knopman
David S
DS
Department of Neurology, Mayo Clinic, Rochester, MN, USA. knopman@mayo.edu
Mosley
Thomas H
TH
Catellier
Diane J
DJ
Sharrett
A Richey
AR
D000367:Age Factors; D000368:Aged; D000375:Aging / Q000473:pathology; D001284:Atrophy / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D015984:Causality; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D015331:Cohort Studies; D015897:Comorbidity; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D048909:Diabetes Complications / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D020547:Lateral Ventricles / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors