Hojeong Kim1, Changsoo Kim2, Sang Won Seo3, Duk L Na3, Hee Jin Kim3, Mira Kang4, Hee-Young Shin4, Seong Kyung Cho4, Sang Eon Park1, Jeongmin Lee1, Jung Won Hwang1, Seun Jeon5, Jong-Min Lee5, Geon Ha Kim3, Hanna Cho3, Byoung Seok Ye3, Young Noh6, Cindy W Yoon7, Eliseo Guallar8. 1. Samsung Advanced Institute for Health Sciences and Technology,Sungkyunkwan University,Seoul,South Korea. 2. Department of Preventive Medicine,Yonsei University College of Medicine,Seoul,South Korea. 3. Department of Neurology,Samsung Medical Center,School of Medicine,Sungkyunkwan University,Seoul,South Korea. 4. Center for Health Promotion,Samsung Medical Center,Seoul,South Korea. 5. Department of Biomedical Engineering,Hanyang University,Seoul,South Korea. 6. Department of Neurology,Gachon University Gil Medical Center,Incheon,South Korea. 7. Department of Neurology,College of Medicine,Inha University,Incheon,South Korea. 8. Departments of Epidemiology and Medicine and Welch Center for Prevention,Epidemiology,and Clinical Research,Johns Hopkins University Bloomberg School of Public Health,Baltimore,Maryland,USA.
Abstract
BACKGROUND: There is increasing evidence of a relationship between underweight or obesity and dementia risk. Several studies have investigated the relationship between body weight and brain atrophy, a pathological change preceding dementia, but their results are inconsistent. Therefore, we aimed to evaluate the relationship between body mass index (BMI) and cortical atrophy among cognitively normal participants. METHODS: We recruited cognitively normal participants (n = 1,111) who underwent medical checkups and detailed neurologic screening, including magnetic resonance imaging (MRI) in the health screening visits between September 2008 and December 2011. The main outcome was cortical thickness measured using MRI. The number of subjects with five BMI groups in men/women was 9/9, 148/258, 185/128, 149/111, and 64/50 in underweight, normal, overweight, mild obesity, and moderate to severe obesity, respectively. Linear and non-linear relationships between BMI and cortical thickness were examined using multiple linear regression analysis and generalized additive models after adjustment for potential confounders. RESULTS: Among men, underweight participants showed significant cortical thinning in the frontal and temporal regions compared to normal weight participants, while overweight and mildly obese participants had greater cortical thicknesses in the frontal region and the frontal, temporal, and occipital regions, respectively. However, cortical thickness in each brain region was not significantly different in normal weight and moderate to severe obesity groups. Among women, the association between BMI and cortical thickness was not statistically significant. CONCLUSIONS: Our findings suggested that underweight might be an important risk factor for pathological changes in the brain, while overweight or mild obesity may be inversely associated with cortical atrophy in cognitively normal elderly males.
BACKGROUND: There is increasing evidence of a relationship between underweight or obesity and dementia risk. Several studies have investigated the relationship between body weight and brain atrophy, a pathological change preceding dementia, but their results are inconsistent. Therefore, we aimed to evaluate the relationship between body mass index (BMI) and cortical atrophy among cognitively normal participants. METHODS: We recruited cognitively normal participants (n = 1,111) who underwent medical checkups and detailed neurologic screening, including magnetic resonance imaging (MRI) in the health screening visits between September 2008 and December 2011. The main outcome was cortical thickness measured using MRI. The number of subjects with five BMI groups in men/women was 9/9, 148/258, 185/128, 149/111, and 64/50 in underweight, normal, overweight, mild obesity, and moderate to severe obesity, respectively. Linear and non-linear relationships between BMI and cortical thickness were examined using multiple linear regression analysis and generalized additive models after adjustment for potential confounders. RESULTS: Among men, underweight participants showed significant cortical thinning in the frontal and temporal regions compared to normal weight participants, while overweight and mildly obeseparticipants had greater cortical thicknesses in the frontal region and the frontal, temporal, and occipital regions, respectively. However, cortical thickness in each brain region was not significantly different in normal weight and moderate to severe obesity groups. Among women, the association between BMI and cortical thickness was not statistically significant. CONCLUSIONS: Our findings suggested that underweight might be an important risk factor for pathological changes in the brain, while overweight or mild obesity may be inversely associated with cortical atrophy in cognitively normal elderly males.
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