Nonalcoholic fatty liver disease and measures of early brain health in middle‐aged adults: The CARDIA study

Abstract

Objective To assess associations between nonalcoholic fatty liver disease (NAFLD) and measures of brain health in a population-based sample of adults. Methods Participants from the CARDIA study (Y25 exam; age 43–55 years) with concurrent CT quantification of liver fat, visceral adipose tissue (VAT) and brain magnetic resonance (MR) images were included (n=505). NAFLD was identified after exclusion of other causes of liver fat. Total tissue volume (TTV) and gray matter cerebral blood flow (GM-CBF) were estimated using 3T brain MR images. Results NAFLD prevalence was 18%. NAFLD was associated with lower TTV and GM-CBF after adjusting for intracranial volume, demographics, and health behaviors (p<0.04 for all). In models with additional adjustment for cardiovascular risk factors the association of NAFLD with GM-CBF remained significant (p=0.04), but was attenuated after adjustment for VAT (p=0.06), and eliminated with BMI (p=0.20). NAFLD was not associated with TTV after adjustment for cardiovascular risk factors (p=0.10), or additional adjustment for VAT (p=0.14) or BMI (p=0.05). Conclusions NAFLD is negatively associated with early brain health as assessed by MR measures of structure (TTV) and perfusion (GM-CBF). BMI and VAT attenuated this relationship providing insight into the potential metabolic role of liver fat in brain health and disease.

Cognitive Changes and Brain Volume Reduction in Patients with Nonalcoholic Fatty Liver Disease

“…Reduced gray and white matter volumes, obtained in our study, combined with the increased volumes of the lateral ventricles, may be used as an explanation why total brain volume did not differ between the examinees and controls, because controls had increased volumes of gray and white matter but lower volumes of the lateral ventricles. According to VanWagner et al (2017) [ 16 ], total brain tissue volume did not differ in groups with and without NAFLD, while gray matter perfusion was lower in NAFLD patients.…”

Importance of fatigue and its measurement in chronic liver disease

“…Some claim there are no associations between fatigue and attention, cognitive performance and brain structure[66]. Others have shown correlations between brain volume[67] and brain health[68]. Despite these differences, imaging is very likely to serve as a biomarker for brain health and possible cognitive function and fatigue in the future[6].…”

Изменения Сосудов Головного Мозга У Пациентов С Неалкогольной Жировой Болезнью Печени И Нарушением Углеводного Обмена

“…It is believed that cerebral hemodynamics due to disruptions in the microcirculation can lead to structural changes in the brain that underlie cognitive impairment (L.B. VanWagner et al, 2017) [9].…”

“…Second, the concurrent presence of chronic systemic inflammation and the metabolic syndrome, which are highly prevalent in NAFLD, have been shown to contribute to cognitive impairment. Finally, obesity, in particular visceral adiposity, is related to neurodegenerative, vascular, and metabolic processes that affect brain structures underlying cognitive function [9].…”