COMPLEX INTERACTIONS BETWEEN OBESITY AND WHITE MATTER: UK BIOBANK STUDY
- Karolina A. Wartolowska (United Kingdom)
Abstract
Background And Aims
Small vessel disease (SVD) is most strongly associated with ageing and hypertension, but the interaction with other modifiable risk factors such as obesity is unclear. This study investigated the effect of obesity on the extent of white matter hyperintensities of vascular origin (WMH) and its interaction with raised blood pressure.
Methods
UK Biobank is a prospective community-based cohort of 502,484 40-69-year-old people, with brain magnetic resonance imaging data available for 45,877 of them. Linear models were used to investigate associations between WMH load (normalised logit-transformed WMH volume) and concurrent mean blood pressure (MAP), pulse pressure (PP), and body mass index (BMI), adjusted for age, sex, diabetes, and smoking.
Results
In fully-adjusted models, BMI was associated with higher WMH load independently of age, high blood pressure, and other cardiovascular risk factors: standardised beta-coefficient for BMI: beta=0.067 95%CI 0.053 to 0.080; PP beta=0.049 95%CIs 0.033 to 0.064; MAP (beta=0.080 95%CIs 0.066 to 0.094 (Figure). Female gender was protective against the negative effects of BMI on WMH compared to male gender, with male gender particularly detrimental in mid-life. Visceral obesity was linked with higher WMH load, beyond the effect of BMI and vascular risk factors.
Conclusions
Obesity is an independent risk factor in the development and progression of white matter hyperintensities, especially in men in midlife. Although the relationships between obesity, blood pressure and WMH are complex, control of BMI may be just as important as good blood pressure control, especially in middle-aged men.
Trial Registration Number
Not applicable.