Sex-specific relationship of cardiometabolic syndrome with lower cortical thickness

Abstract

ObjectiveTo investigate whether cardiometabolic factors were associated with age-related differences in cortical thickness in relation to sex.MethodsIn this cross-sectional study, we enrolled 1,322 cognitively normal elderly (≥65 years old) individuals (774 [58.5%] men, 548 [41.5%] women). We measured cortical thickness using a surface-based analysis. We analyzed the associations of cardiometabolic risk factors with cortical thickness using multivariate linear regression models after adjusting for possible confounders and interactions with age.ResultAmong women, hypertension (β = −1.119 to −0.024, p < 0.05) and diabetes mellitus (β = −0.920, p = 0.03) were independently associated with lower mean cortical thickness. In addition, there was an interaction effect between obesity (body mass index [BMI] ≥27.5 kg/m2) and age on cortical thickness in women (β = −0.324 to −0.010, p < 0.05), suggesting that age-related differences in cortical thickness were more prominent in obese women compared to women with normal weight. Moreover, low education level (<6 years) was correlated with lower mean cortical thickness (β = −0.053 to −0.046, p < 0.05). Conversely, among men, only being underweight (BMI ≤18.5 kg/m2, β = −2.656 to −0.073, p < 0.05) was associated with lower cortical thickness.ConclusionsOur findings suggest that cortical thickness is more vulnerable to cardiometabolic risk factors in women than in men. Therefore, sex-specific prevention strategies may be needed to protect against accelerated brain aging.

Gait and balance disturbances are common in young urbanites and associated with cognitive impairment. Air pollution and the historical development of Alzheimer's disease in the young

“… 38 , 39 Metabolic and genetic factors also have to be considered when we analyzed motor and cognitive decline and the work of Sathyan et al, 88 precisely describing high BMI and waist circumference associated with high risk of MCR syndrome, an observation that is not a surprise in view of the literature linking insulin resistance, NVU abnormalities, endothelial dysfunction and certainly inflammation to the development of Alzheimer’s disease. 97 , 98 , 99 , 100 Ethnicity has to be included among the risk factors and Hispanics and particularly Mexican and Mexican-American individuals carry higher risk of cardiometabolic diseases and AD. 101 , 102 , 103 Slow gait and risk of cognitive impairment are also described in APOE4 carriers 94 , a finding relevant to our MMC populations carrying an allele 4 in∼20% and accelerating AD neuropathology staging in the first 2 decades of life.…”

Sex-dependent effect of APOE on Alzheimer's disease and other age-related neurodegenerative disorders

“…This could explain the increased risk for vascular dementia (Box 1) in males (Ruitenberg et al, 2001), hypothesized to be attributed to a reduced activity of enzymes in the renin-angiotensin system (Box 1) specifically in males (Fernandez-Atucha et al, 2017). Interestingly, although hypertension is more common in middle-aged men, it is only a risk factor for dementia in women (Gilsanz et al, 2017) and is only associated with reduced cortical thickness in women (Kim et al, 2019). Women with poor metabolic phenotypes and high blood pressure have impaired cognitive performance compared to healthy post-menopausal women (Rettberg et al, 2016).…”

Gender-Based Analysis of Risk Factors for Dementia Using Senior Cohort

“…Therefore, we investigated the related studies to examine the question of whether there are gender differences in dementia risk factors. Many studies have been conducted of gender differences in dementia risk factors [ 5 , 6 , 7 ], and several have been conducted using neuroimaging, such as Magnetic Resonance Imaging (MRI) and Positron Emission Tomography Scan (PET) [ 7 , 8 ].…”

“…Seo et al [ 7 ] conducted a study of gender differences in dementia risk factors related to cardiac metabolic risk factors. MRI images were used to measure the relation between cortical thickness and cardiac metabolic risk, one of the dementia risk factors for both men and women.…”