Metabolic syndrome alters relationships between cardiometabolic variables, cognition and white matter hyperintensity load

Abstract

Cardiometabolic risk factors influence white matter hyperintensity (WMH) development: in metabolic syndrome (MetS), higher WMH load is often reported but the relationships between specific cardiometabolic variables, WMH load and cognitive performance are uncertain. We investigated these in a Brazilian sample (aged 50–85) with (N = 61) and without (N = 103) MetS. Stepwise regression models identified effects of cardiometabolic and demographic variables on WMH load (from FLAIR MRI) and verbal recall performance. WMH volume was greater in MetS, but verbal recall performance was not impaired. Age showed the strongest relationship with WMH load. Across all participants, systolic blood pressure (SBP) and fasting blood glucose were also contributors, and WMH volume was negatively associated with verbal recall performance. In non-MetS, higher HbA1c, SBP, and number of MetS components were linked to poorer recall performance while higher triglyceride levels appeared to be protective. In MetS only, these relationships were absent but education exerted a strongly protective effect on recall performance. Thus, results support MetS as a construct: the clustering of cardiometabolic variables in MetS alters their individual relationships with cognition; instead, MetS is characterised by a greater reliance on cognitive reserve mechanisms. In non-MetS, strategies to control HbA1c and SBP should be prioritised as these have the largest impact on cognition.

Higher Blood Pressure is Associated with Greater White Matter Lesions and Brain Atrophy: A Systematic Review with Meta-Analysis

“…Eight studies provided data on WMLs that could be pooled (n = 3696, MWA = 58.2 years, women = 45.5%, hypertension = 33.1%) (Table 1). The meta-analysis of seven crosssectional studies indicated that every one standard deviation (SD) increase in SBP above 120 mmHg was associated with 108 mm 3 (95% CI 23,193, P = 0.0128) larger WMLs (Figure 5A) [20,29,31,36,39,43,45]. No association was detected across three longitudinal studies with a mean weighted length of follow-up of 2 years.…”

“…All analyses were adjusted for ICV, and age (Figure 5B) (Supplementary Information; Figures S1-S3) [39,45,52,61]. A sensitivity analysis was conducted to investigate whether the association between SBP and WMLs volume differs between younger and older individuals [20,29,31,36,39,43,45]. Since most studies reported a mean age above~60 years, the available studies were stratified based on a sample mean age + 2 SD falling above or below 75 years.…”

Serum metabolomic biomarkers of perceptual speed in cognitively normal and mildly impaired subjects with fasting state stratification

“…It has recently become clear that cardiometabolic disorders and associated low-grade systemic inflammation and altered lipid and energy metabolism, are risk factors for AD 3–5 . Therefore, changes in circulating markers of low-grade inflammation and metabolism may track these pertinent metabolic changes.…”

Association of plasma and CSF cytochrome P450, soluble epoxide hydrolase and ethanolamides metabolism with Alzheimer’s disease

“…Colors shows 60% probability cutoffs for: red -fasted; blue -non-fasted. Cholesterol (top of the pathway) is converted to primary bile acids along two pathways, neutral and acidic [1]. Further, primary bile acids are secreted to gut, and portion of it being modify by the gut bacteria to secondary bile acids.…”

“…Risk factors for Alzheimer's disease (AD) include cardiometabolic disorders, low-grade systemic inflammation and altered lipid and energy metabolism [1][2][3]. Lipid mediators are lipid derived signaling molecules that regulate both acute and low-grade systemic inflammation and energy metabolism along with other processes [4].…”