Albuminuria, Cerebrovascular Disease and Cortical Atrophy: among Cognitively Normal Elderly Individuals

• DOI: 10.1038/srep20692
• Publication Date: 2016-02-16T11:15:45Z
• Authors: Eun Bin Cho; Hee-Young Shin; Sang Eon Park; Phillip Chun; Hye Ryoun Jang; Jin-ju Yang; Hee Jin Kim; Yeo Jin Kim; Na-Yeon Jung; Jin San Lee; Juyoun Lee; Young Kyoung Jang; Eun Young Jang; Mira Kang; Jong-Min Lee; Changsoo Kim; Ju-Hong Min; Seungho Ryu; Duk L. Na; Sang Won Seo
• Keywords: Adult; Male; Chronic/complications; Cerebrovascular Disorders/psychology; 610; Chronic/diagnosis; Comorbidity; Article; Magnetic Resonance Imaging/methods; 618; 03 medical and health sciences; Cerebral Cortex/pathology*; Cognition; 0302 clinical medicine; Risk Factors; 80 and over; Albuminuria/epidemiology; Albuminuria; Humans; Renal Insufficiency; Renal Insufficiency, Chronic; Chronic/epidemiology; Aged; Aged, 80 and over; Cerebral Cortex; Cerebrovascular Disorders/etiology*; Albuminuria/physiopathology; Albuminuria/complications*; Middle Aged; Magnetic Resonance Imaging; 3. Good health; Cerebrovascular Disorders/epidemiology; Cerebrovascular Disorders; Albuminuria/etiology; Cerebrovascular Disorders/pathology*; Population Surveillance; Female; Atrophy; Glomerular Filtration Rate

AbstractWe tested the hypothesis that decreased glomerular filtration rate and albuminuria have different roles in brain structure alterations. We enrolled 1,215 cognitively normal individuals, all of whom underwent high-resolution T1-weighted volumetric magnetic resonance imaging scans. The cerebral small vessel disease burdens were assessed with white matter hyperintensities (WMH), lacunes, and microbleeds. Subjects were considered to have an abnormally elevated urine albumin creatinine ratio if the value was ≥17 mg/g for men and ≥25 mg/g for women. Albuminuria, but not estimated glomerular filtration rate (eGFR), was associated with increased WMH burdens (p = 0.002). The data was analyzed after adjusting for age, sex, education, history of hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, stroke, total cholesterol level, body mass index, status of smoking and alcohol drinking, and intracranial volume. Albuminuria was also associated with cortical thinning, predominantly in the frontal and occipital regions (both p < 0.01) in multiple linear regression analysis. However, eGFR was not associated with cortical thickness. Furthermore, path analysis for cortical thickness showed that albuminuria was associated with frontal thinning partially mediated by WMH burdens. The assessment of albuminuria is needed to improve our ability to identify individuals with high risk for cognitive impairments, and further institute appropriate preventive measures.