Visceral fat is associated with lower brain volume in healthy middle-aged adults

Authors

  • Stéphanie Debette MD, PhD,

    1. Department of Neurology, Boston University School of Medicine, Framingham Heart Study, Boston, MA
    2. National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA
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  • Alexa Beiser PhD,

    1. Department of Neurology, Boston University School of Medicine, Framingham Heart Study, Boston, MA
    2. National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA
    3. Department of Biostatistics, Boston University School of Public Health, Boston, MA
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  • Udo Hoffmann MD,

    1. Division of Endocrinology, Metabolism, and Diabetes, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
    2. Department of Radiology, Masachusetts General Hospital and Harvard Medical School, Boston, MA
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  • Charles DeCarli MD,

    1. Department of Neurology, University of California at Davis, Sacramento, CA
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  • Christopher J. O'Donnell MD, MPH,

    1. National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA
    2. Department of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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  • Joseph M. Massaro PhD,

    1. National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA
    2. Department of Biostatistics, Boston University School of Public Health, Boston, MA
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  • Rhoda Au PhD,

    1. Department of Neurology, Boston University School of Medicine, Framingham Heart Study, Boston, MA
    2. National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA
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  • Jayandra J. Himali MS,

    1. Department of Neurology, Boston University School of Medicine, Framingham Heart Study, Boston, MA
    2. National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA
    3. Department of Biostatistics, Boston University School of Public Health, Boston, MA
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  • Philip A. Wolf MD,

    1. Department of Neurology, Boston University School of Medicine, Framingham Heart Study, Boston, MA
    2. National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA
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  • Caroline S. Fox MD, MPH,

    1. National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA
    2. Division of Endocrinology, Metabolism, and Diabetes, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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  • Sudha Seshadri MD, DM

    Corresponding author
    1. Department of Neurology, Boston University School of Medicine, Framingham Heart Study, Boston, MA
    2. National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA
    • Department of Neurology, Boston University School of Medicine; B602, 72 East Concord Street, Boston, MA 02118
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Abstract

Objective

Midlife obesity has been associated with an increased risk of dementia. The underlying mechanisms are poorly understood. Our aim was to examine the cross-sectional association of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and computed tomography (CT)-based measurements of subcutaneous (SAT) and visceral (VAT) adipose tissue with various magnetic resonance imaging (MRI) markers of brain aging in middle-aged community adults.

Methods

Participants from the Framingham Offspring cohort were eligible if in addition to having measurements of BMI, WC, WHR, SAT, and VAT, they had undergone a volumetric brain MRI scan with measurements of total brain volume (TCBV), temporal horn volume (THV), white matter hyperintensity volume (WMHV), and MRI-defined brain infarcts (BI). All analyses were adjusted for age, sex, and time interval between abdominal CT and brain MRI.

Results

In a sample of 733 community participants (mean age, 60 years; 53% women), we observed an inverse association of BMI (estimate by standard deviation unit ± standard error = −0.27 ± 0.12; p = 0.02), WC (−0.30 ± 0.12; p = 0.01), WHR (−0.37 ± 0.12; p = 0.02), SAT (−0.23 ± 0.11; p = 0.04), and VAT (−0.36 ± 0.12; p = 0.002) with TCBV, independent of vascular risk factors. The association between VAT and TCBV was the strongest and most robust, and was also independent of BMI (−0.35 ± 0.15; p = 0.02) and insulin resistance (−0.32 ± 0.13; p = 0.01). When adjusting for C-reactive protein levels, the associations were attenuated (−0.17 ± 0.13; p = 0.17 for VAT). No consistently significant association was observed between the anthropometric or CT-based abdominal fat measurements and THV, WMHV, or BI.

Interpretation

In middle-aged community participants, we observed a significant inverse association of anthropometric and CT-based measurements of abdominal, especially visceral, fat with total brain volume. ANN NEUROL 2010

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