title: Visceral adiposity predicts subclinical white matter hyperintensities in middle-aged adults.
abstract: Growing prevalence of neuropathology and cognitive impairment are emerging consequences of the obesity epidemic. Adiposity indices used in examining the relationships between obesity, neuropathology, and cognition vary substantially in the literature leading to incongruent findings. Our aim was to determine the anthropometric measures most strongly associated with early white matter disease and cognitive function at midlife.
  
  
  
  Multiple adiposity indices were measured in 126 adults aged 40-62 who also completed a magnetic resonance imaging (MRI) scan to quantify white matter disease and a cognitive test battery. Anthropometric indices of obesity were compared to image-based estimates of visceral adipose tissue with dual-energy X-ray absorptiometry (DEXA) as predictors of current white matter disease and cognitive function. We also explored sex as a potential moderator of these relationships.
  
  
  
  Waist circumference (WC) was most strongly correlated with DEXA estimates of visceral adipose tissue (r=0.871, p<0.001). Increasing WC (β=0.231, p=0.034), percent body fat (β=0.230, p=0.045), and VAT (β=0.247, p=0.027) significantly predicted subclinical white matter hyperintensities in the absence of cognitive impairment after accounting for age, sex, years of education, and cardiovascular risk factors. Sex was not a significant moderator of any of the observed relationships.
  
  
  
  Of the anthropometric indices used in this study, WC, BF, and VAT successfully predicted subclinical white matter disease in cognitively normal adults at midlife. Increasing VAT may independently insidiously affect cerebral white matter prior to detectable cognitive changes, necessitating early intervention.
authors.affiliation: Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, United States.
authors.forename: Evan P
authors.initials: EP
authors.lastname: Pasha
authors.affiliation: Department of Psychology, The University of Texas at Austin, Austin, TX 78712, United States.
authors.forename: Alex
authors.initials: A
authors.lastname: Birdsill
authors.affiliation: Department of Psychology, The University of Texas at Austin, Austin, TX 78712, United States.
authors.forename: Paige
authors.initials: P
authors.lastname: Parker
authors.affiliation: Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, United States.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elmenshawy
authors.affiliation: Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, United States.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Psychology, The University of Texas at Austin, Austin, TX 78712, United States; Imaging Research Center, The University of Texas at Austin, Austin, TX 78712, United States. Electronic address: haley@austin.utexas.edu.
authors.forename: Andreana P
authors.initials: AP
authors.lastname: Haley
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D056128:Obesity, Abdominal / Q000000981:diagnostic imaging*; D050177:Overweight / Q000000981:diagnostic imaging*; D055105:Waist Circumference / Q000502:physiology; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: Cognitive function; DEXA; MRI; Neuropathology; Obesity