Nonalcoholic fatty liver disease and cognitive impairment: A prospective cohort study

被引:14
作者
Cushman, Mary A. [1 ,2 ]
Callas, Peter D. [1 ,3 ]
Alexander, Kristine W. [1 ]
Wadley, Virginia E. [4 ]
Zakai, Neil D. [1 ,2 ]
Lidofsky, Steven D. [1 ]
Unverzagt, Frederick D. [5 ]
Judd, Suzanne D. [6 ]
机构
[1] Univ Vermont, Dept Med, Larner Coll Med, Burlington, VT 05405 USA
[2] Univ Vermont, Dept Pathol & Lab Med, Larner Coll Med, Burlington, VT 05405 USA
[3] Univ Vermont, Dept Math & Stat, Burlington, VT USA
[4] Univ Alabama Birmingham, Dept Med, Div Gerontol Geriatr & Palliat Care, Birmingham, AL USA
[5] Indiana Univ Sch Med, Dept Psychiat, Indianapolis, IN USA
[6] Univ Alabama Birmingham, Dept Biostat, Birmingham, AL USA
基金
美国国家卫生研究院;
关键词
GAMMA-GLUTAMYL-TRANSFERASE; BODY-MASS INDEX; RACIAL-DIFFERENCES; INSULIN-RESISTANCE; METABOLIC SYNDROME; EXTERNAL VALIDATION; HEPATIC STEATOSIS; STROKE RISK; REASONS; DEMENTIA;
D O I
10.1371/journal.pone.0282633
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background & aimsNonalcoholic fatty liver disease (NAFLD) is prevalent and may affect cognitive function. We studied associations of NAFLD with risk of cognitive impairment. Secondarily we evaluated liver biomarkers (alanine aminotransferase (ALT), aspartate aminotransferase (AST), their ratio, and gamma-glutamyl transpeptidase). MethodsIn a prospective cohort study, the REasons for Geographic and Racial Differences in Stroke, among 30,239 black and white adults aged & GE;45,495 cases of incident cognitive impairment were identified over 3.4 years follow up. Cognitive impairment was identified as new impairment in two of three cognitive tests administered every two years during follow up; word list learning and recall, and verbal fluency. 587 controls were selected from an age, race, sex-stratified sample of the cohort. The fatty liver index was used to define baseline NAFLD. Liver biomarkers were measured using baseline blood samples. ResultsNAFLD at baseline was associated with a 2.01-fold increased risk of incident cognitive impairment in a minimally adjusted model (95% CI 1.42, 2.85). The association was largest in those aged 45-65 (p interaction by age = 0.03), with the risk 2.95-fold increased (95% CI 1.05, 8.34) adjusting for cardiovascular, stroke and metabolic risk factors. Liver biomarkers were not associated with cognitive impairment, except AST/ALT >2, with an adjusted OR 1.86 (95% CI 0.81, 4.25) that did not differ by age. ConclusionsA laboratory-based estimate of NAFLD was associated with development of cognitive impairment, particularly in mid-life, with a tripling in risk. Given its high prevalence, NAFLD may be a major reversible determinant of cognitive health.
引用
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页数:15
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