Metabolic syndrome and localization of white matter hyperintensities in the elderly population.
BACKGROUND
Metabolic syndrome (MetS) is defined as a clustering of metabolic disorders: abdominal obesity, dyslipidemia, hypertension, and hyperglycemia. Although specific components of MetS have been associated with white matter hyperintensities (WMH), less is known about the association between MetS as a whole and WMH, especially in normal aging. We aimed to: (1) investigate this association in a cohort of healthy elderly individuals, and (2) examine the relationship between MetS and the regional distribution of WMH, to further understanding of the relationship between MetS and structural brain changes.


METHODS
Analyses were carried out on 308 participants (48.1% men, age: 71.0 ± 3.9 years) from the French longitudinal ESPRIT (Enquête de Santé Psychologique--Risques, Incidence et Traitement) study, who were free of cerebrovascular disease cognitive and functional impairment. Logistic regression models were used to examine the cross-sectional association between MetS (defined using the National Cholesterol Education Program-Adult Treatment Panel III criteria) and (1) WMH volumes, and (2) WMH volumes according to their localization in insulofrontal and temporoparietal regions.


RESULTS
After adjusting for potential confounders, participants with MetS had a twofold increased chance of presenting with high levels of WMH volume compared with those without (odds ratio [OR] = 2.74, 95% confidence interval [CI]: 1.25-6.03). MetS was specifically associated with an increase of temporoparietal WMH volumes, but no association was found between MetS and WMH localized in the insulofrontal region.


CONCLUSIONS
Our findings suggest that effective management of MetS may reduce WMH accumulation in brain areas already vulnerable to the aging process.
Inserm, Unit 1061, Neuropsychiatry, Epidemiological and Clinical Research, Montpellier, France.
Florence
F
Portet
Adam M
AM
Brickman
Yaakov
Y
Stern
Nikolaos
N
Scarmeas
Jordan
J
Muraskin
Frank A
FA
Provenzano
Claudine
C
Berr
Alain
A
Bonafé
Sylvaine
S
Artero
Karen
K
Ritchie
Tasnime N
TN
Akbaraly
D000368:Aged; D000375:Aging / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D016017:Odds Ratio