Dean Shibata1, Astrid Suchy-Dicey2, Cara L Carty2,3, Tara Madhyastha4,5, Tauqeer Ali6, Lyle Best7, Thomas J Grabowski5,8, W T Longstreth8,9, Dedra Buchwald2,3. 1. Department of Radiology, University of Washington, Seattle, Washington, USA, shibatad@uw.edu. 2. Partnerships for Native Health, Washington State University, Pullman, Washington, USA. 3. Elson S Floyd College of Medicine, Washington State University, Seattle, Washington, USA. 4. Department of Radiology, University of Washington, Seattle, Washington, USA. 5. Integrated Brain Imaging Center, University of Washington, Seattle, Washington, USA. 6. Center for American Indian Health Research, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. 7. Strong Heart Study-Dakota Center, Eagle Butte, South Dakota, USA. 8. Department of Neurology, University of Washington, Seattle, Washington, USA. 9. Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Abstract
BACKGROUND: Clinical stroke is prevalent in American Indians, but the lifestyle risk factors for vascular brain injury have not been well-studied in this population. The purpose of this study was to correlate brain magnetic resonance imaging (MRI) findings with obesity, alcohol use, and smoking behaviors in elderly American Indians from the Strong Heart Study. METHODS: Cranial MRI scans (n = 789) were analyzed for dichotomous measures of infarcts, hemorrhages, white matter hyperintensities (WMH), and cerebral atrophy and continuous measures of total brain, WMH, and hippocampal volume. Poisson regression was used to estimate prevalence ratios, and linear regression was used to estimate measures of association for continuous outcomes. Models were adjusted for the risk factors of interest as well as age, sex, study site, income, education, hypertension, diabetes, and low-density lipoprotein cholesterol. RESULTS: Smoking was associated with increased hippocampal atrophy (p = 0.002) and increased prevalence of sulcal widening (p < 0.001). Relative to nonsmokers, smokers with more than 25 pack-years of smoking had a 27% (95% CI 7-47%) increased prevalence of high-grade sulci, p = 0.005. Body mass index was inversely associated with prevalence of nonlacunar infarcts and sulcal widening (all p = 0.004). Alcohol use was not significantly associated with any of the measured MRI findings. CONCLUSIONS: This study found similar associations between smoking and vascular brain injury among American Indians, as seen in other populations. In particular, these findings support the role of smoking as a key correlate for cerebral atrophy.
BACKGROUND: Clinical stroke is prevalent in American Indians, but the lifestyle risk factors for vascular brain injury have not been well-studied in this population. The purpose of this study was to correlate brain magnetic resonance imaging (MRI) findings with obesity, alcohol use, and smoking behaviors in elderly American Indians from the Strong Heart Study. METHODS: Cranial MRI scans (n = 789) were analyzed for dichotomous measures of infarcts, hemorrhages, white matter hyperintensities (WMH), and cerebral atrophy and continuous measures of total brain, WMH, and hippocampal volume. Poisson regression was used to estimate prevalence ratios, and linear regression was used to estimate measures of association for continuous outcomes. Models were adjusted for the risk factors of interest as well as age, sex, study site, income, education, hypertension, diabetes, and low-density lipoprotein cholesterol. RESULTS: Smoking was associated with increased hippocampal atrophy (p = 0.002) and increased prevalence of sulcal widening (p < 0.001). Relative to nonsmokers, smokers with more than 25 pack-years of smoking had a 27% (95% CI 7-47%) increased prevalence of high-grade sulci, p = 0.005. Body mass index was inversely associated with prevalence of nonlacunar infarcts and sulcal widening (all p = 0.004). Alcohol use was not significantly associated with any of the measured MRI findings. CONCLUSIONS: This study found similar associations between smoking and vascular brain injury among American Indians, as seen in other populations. In particular, these findings support the role of smoking as a key correlate for cerebral atrophy.
Authors: Ira Driscoll; Sarah A Gaussoin; Sylvia Wassertheil-Smoller; Marian Limacher; Ramon Casanova; Kristine Yaffe; Susan M Resnick; Mark A Espeland Journal: J Gerontol A Biol Sci Med Sci Date: 2016-03-09 Impact factor: 6.053
Authors: R N Bryan; J Cai; G Burke; R G Hutchinson; D Liao; J F Toole; A P Dagher; L Cooper Journal: AJNR Am J Neuroradiol Date: 1999-08 Impact factor: 3.825
Authors: D S Knopman; A D Penman; D J Catellier; L H Coker; D K Shibata; A R Sharrett; T H Mosley Journal: Neurology Date: 2011-05-04 Impact factor: 9.910
Authors: E T Lee; L D Cowan; T K Welty; M Sievers; W J Howard; A Oopik; W Wang; J Yeh; R B Devereux; E R Rhoades; R R Fabsitz; O Go; B V Howard Journal: Am J Epidemiol Date: 1998-06-01 Impact factor: 4.897
Authors: K Park; N Yasuda; S Toyonaga; E Tsubosaki; H Nakabayashi; K Shimizu Journal: J Neurol Neurosurg Psychiatry Date: 2008-02-12 Impact factor: 10.154