Nonalcoholic fatty liver disease and measures of early brain health in middle‐aged adults: The CARDIA study

• Published in: Obesity (Silver Spring, Md.) Vol. 25; no. 3; pp. 642 - 651
• Main Authors: VanWagner, Lisa B., Terry, James G., Chow, Lisa S., Alman, Amy C., Kang, Hakmook, Ingram, Katherine H., Shay, Christina, Lewis, Cora E., Bryan, R. Nick, Launer, Lenore J., Jeffrey Carr, J.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.03.2017
• Subjects: Abdomen; Age; Aging; Alzheimer's disease; Automation; Body mass index; Brain - diagnostic imaging; Cognitive ability; Exercise; Female; Health Behavior; Health risk assessment; Humans; Insulin resistance; Intra-Abdominal Fat - diagnostic imaging; Liver - diagnostic imaging; Liver diseases; Magnetic Resonance Spectroscopy; Male; Medical imaging; Metabolism; Middle age; Middle Aged; NMR; Non-alcoholic Fatty Liver Disease - diagnostic imaging; Non-alcoholic Fatty Liver Disease - epidemiology; Nuclear magnetic resonance; Obesity; Organ Size; Physical fitness; Physiology; Population; Prevalence; Quality control; Risk Factors; Tomography, X-Ray Computed - methods; Young adults
• ISSN: 1930-7381; 1930-739X
• DOI: 10.1002/oby.21767

Objective To assess associations between nonalcoholic fatty liver disease (NAFLD) and measures of brain health in a population‐based sample of adults. Methods Participants from the CARDIA study (Y25 exam; age 43‐55 years) with concurrent computed tomography quantification of liver fat, visceral adipose tissue (VAT), and brain magnetic resonance (MR) images were included (n = 505). NAFLD was identified after exclusion of other causes of liver fat. Total tissue volume (TTV) and gray matter cerebral blood flow (GM‐CBF) were estimated using 3T brain MR images. Results NAFLD prevalence was 18%. NAFLD was associated with lower TTV and GM‐CBF after adjusting for intracranial volume, demographics, and health behaviors (P < 0.04 for all). In models with additional adjustment for cardiovascular risk factors, the association of NAFLD with GM‐CBF remained significant (P = 0.04) but was attenuated after adjustment for VAT (P = 0.06) and eliminated with BMI (P = 0.20). NAFLD was not associated with TTV after adjustment for cardiovascular risk factors (P = 0.10) or additional adjustment for VAT (P = 0.14) or BMI (P = 0.05). Conclusions NAFLD is negatively associated with early brain health as assessed by MR measures of structure (TTV) and perfusion (GM‐CBF). BMI and VAT attenuated this relationship, providing insight into the potential metabolic role of liver fat in brain health and disease.