title: Albuminuria, Cerebrovascular Disease and Cortical Atrophy: among Cognitively Normal Elderly Individuals.
abstract: We tested the hypothesis that decreased glomerular filtration rate and albuminuria have different roles in brain structure alterations. We enrolled 1,215 cognitively normal individuals, all of whom underwent high-resolution T1-weighted volumetric magnetic resonance imaging scans. The cerebral small vessel disease burdens were assessed with white matter hyperintensities (WMH), lacunes, and microbleeds. Subjects were considered to have an abnormally elevated urine albumin creatinine ratio if the value was ≥17 mg/g for men and ≥25 mg/g for women. Albuminuria, but not estimated glomerular filtration rate (eGFR), was associated with increased WMH burdens (p = 0.002). The data was analyzed after adjusting for age, sex, education, history of hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, stroke, total cholesterol level, body mass index, status of smoking and alcohol drinking, and intracranial volume. Albuminuria was also associated with cortical thinning, predominantly in the frontal and occipital regions (both p < 0.01) in multiple linear regression analysis. However, eGFR was not associated with cortical thickness. Furthermore, path analysis for cortical thickness showed that albuminuria was associated with frontal thinning partially mediated by WMH burdens. The assessment of albuminuria is needed to improve our ability to identify individuals with high risk for cognitive impairments, and further institute appropriate preventive measures.
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.|Department of Neurology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.
authors.forename: Eun Bin
authors.initials: EB
authors.lastname: Cho
authors.affiliation: Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hee-Young
authors.initials: HY
authors.lastname: Shin
authors.affiliation: Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.
authors.forename: Sang Eon
authors.initials: SE
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine Behavioral Emergencies Research Lab, San Diego, CA, USA.|Department of Biology, University of California San Diego, CA, USA.
authors.forename: Phillip
authors.initials: P
authors.lastname: Chun
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hye Ryoun
authors.initials: HR
authors.lastname: Jang
authors.affiliation: Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
authors.forename: Jin-ju
authors.initials: JJ
authors.lastname: Yang
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.
authors.forename: Yeo Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Pusan National University Hospital, Pusan National University College of Medicine and Biomedical Research Institute, Busan, Korea.
authors.forename: Na-Yeon
authors.initials: NY
authors.lastname: Jung
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.
authors.forename: Jin San
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.
authors.forename: Juyoun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.
authors.forename: Young Kyoung
authors.initials: YK
authors.lastname: Jang
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Jang
authors.affiliation: Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Mira
authors.initials: M
authors.lastname: Kang
authors.affiliation: Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine and the Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Korea.|Divison of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Changsoo
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.
authors.forename: Ju-Hong
authors.initials: JH
authors.lastname: Min
authors.affiliation: Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seungho
authors.initials: S
authors.lastname: Ryu
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.
authors.forename: Duk L
authors.initials: DL
authors.lastname: Na
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine.|Neuroscience Center, Samsung Medical Center, Seoul, Korea.|Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.|Department of Clinical Research Design &Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Seo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000150:complications* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D001284:Atrophy; D002540:Cerebral Cortex / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology* / Q000523:psychology; D003071:Cognition; D015897:Comorbidity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors