Pauline H Croll1, Mirte Boelens2, Meike W Vernooij3, Ondine van de Rest4, M Carola Zillikens5, M Arfan Ikram6, Trudy Voortman7. 1. Department of Epidemiology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015, GD, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015, GD, Rotterdam, the Netherlands. Electronic address: p.croll@erasmusmc.nl. 2. Department of Epidemiology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015, GD, Rotterdam, the Netherlands. Electronic address: m.boelens.1@erasmusmc.nl. 3. Department of Epidemiology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015, GD, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015, GD, Rotterdam, the Netherlands. Electronic address: m.vernooij@erasmusmc.nl. 4. Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands. Electronic address: ondine.vanderest@wur.nl. 5. Department of Internal Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015, GD, Rotterdam, the Netherlands. Electronic address: m.c.zillikens@erasmusmc.nl. 6. Department of Epidemiology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015, GD, Rotterdam, the Netherlands. Electronic address: m.a.ikram@erasmusmc.nl. 7. Department of Epidemiology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015, GD, Rotterdam, the Netherlands. Electronic address: trudy.voortman@erasmusmc.nl.
Abstract
BACKGROUND & AIM: Vitamin D deficiency has been linked to an increased risk of dementia. To strengthen this evidence and establish whether vitamin D can indeed play a role in early prevention of neurodegeneration, knowledge on underlying pathways is crucial. Therefore, we aimed to investigate the association of vitamin D status with brain tissue volumes, hippocampus volume, white matter integrity, and markers of cerebral small vessel disease (CSVD) in a dementia-free population. METHODS: In this cross-sectional analysis, 2,716 participants free of dementia from the population-based Rotterdam Study underwent serum 25(OH)D concentration assessment and brain magnetic resonance imaging (MRI) scanning between 2006 and 2009. Outcomes of interest included brain tissue volume (total, white matter, grey matter and hippocampus volume), white matter integrity (fractional anisotropy (FA) and mean diffusivity (MD)), and markers of CSVD (white matter hyper intensity (WMH) volume, presence of lacunes and microbleeds). Associations between vitamin D status, both in categories and continuous, and these brain measurements were assessed using multivariable linear and logistic regression models, adjusting for lifestyle and other disease risk factors. RESULTS: We observed that vitamin D deficiency (25(OH)D < 30 nmol/L) was independently associated with smaller brain tissue volume, smaller white matter volume and smaller hippocampus volume as compared to a sufficient vitamin D status (≥50 nmol/L). Vitamin D per 10 nmol/L increment and an insufficient (30-50 nmol/L) as compared to sufficient vitamin D status were not associated with the brain measures of interest. Moreover, vitamin D status was not associated with grey matter volume, white matter integrity or CSVD markers. CONCLUSIONS: In this dementia-free population, vitamin D deficiency was associated with a smaller brain tissue volume and hippocampus volume. More research, in particular with a longitudinal design, is needed to further elucidate the role of vitamin D in neurodegeneration.
BACKGROUND & AIM: Vitamin D deficiency has been linked to an increased risk of dementia. To strengthen this evidence and establish whether vitamin D can indeed play a role in early prevention of neurodegeneration, knowledge on underlying pathways is crucial. Therefore, we aimed to investigate the association of vitamin D status with brain tissue volumes, hippocampus volume, white matter integrity, and markers of cerebral small vessel disease (CSVD) in a dementia-free population. METHODS: In this cross-sectional analysis, 2,716 participants free of dementia from the population-based Rotterdam Study underwent serum 25(OH)D concentration assessment and brain magnetic resonance imaging (MRI) scanning between 2006 and 2009. Outcomes of interest included brain tissue volume (total, white matter, grey matter and hippocampus volume), white matter integrity (fractional anisotropy (FA) and mean diffusivity (MD)), and markers of CSVD (white matter hyper intensity (WMH) volume, presence of lacunes and microbleeds). Associations between vitamin D status, both in categories and continuous, and these brain measurements were assessed using multivariable linear and logistic regression models, adjusting for lifestyle and other disease risk factors. RESULTS: We observed that vitamin D deficiency (25(OH)D < 30 nmol/L) was independently associated with smaller brain tissue volume, smaller white matter volume and smaller hippocampus volume as compared to a sufficient vitamin D status (≥50 nmol/L). Vitamin D per 10 nmol/L increment and an insufficient (30-50 nmol/L) as compared to sufficient vitamin D status were not associated with the brain measures of interest. Moreover, vitamin D status was not associated with grey matter volume, white matter integrity or CSVD markers. CONCLUSIONS: In this dementia-free population, vitamin D deficiency was associated with a smaller brain tissue volume and hippocampus volume. More research, in particular with a longitudinal design, is needed to further elucidate the role of vitamin D in neurodegeneration.
Authors: Mariluce Rodrigues Marques Silva; Waleska Maria Almeida Barros; Mayara Luclécia da Silva; José Maurício Lucas da Silva; Ana Patrícia da Silva Souza; Ana Beatriz Januário da Silva; Matheus Santos de Sousa Fernandes; Sandra Lopes de Souza; Viviane de Oliveira Nogueira Souza Journal: Clinics (Sao Paulo) Date: 2021-11-08 Impact factor: 2.365