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Mid-life adiposity factors relate to blood-brain barrier integrity in late life.

Journal article
Authors Deborah Gustafson
C Karlsson
Ingmar Skoog
Lars Rosengren
Lauren Lissner
Kaj Blennow
Published in Journal of internal medicine
Volume 262
Issue 6
Pages 643-50
ISSN 1365-2796
Publication year 2007
Published at Institute of Medicine, School of Public Health and Community Medicine
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Pages 643-50
Language en
Keywords Aged, Aged, 80 and over, Albumins, cerebrospinal fluid, Biological Markers, blood, cerebrospinal fluid, Blood-Brain Barrier, Female, Humans, Leptin, blood, Linear Models, Middle Aged, Obesity, blood, cerebrospinal fluid, Overweight, blood, cerebrospinal fluid, Retrospective Studies, Serum Albumin, analysis, Sex Hormone-Binding Globulin, analysis
Subject categories Psychiatry, Public health medicine research areas


OBJECTIVE: We explored the relationship between adiposity factors measured during mid-life and blood-brain barrier (BBB) integrity measured via the cerebrospinal fluid/serum (CSF/S) albumin ratio in late life. Adiposity factors included body mass index and blood levels of sex hormone binding globulin (SHBG) and leptin. Design. Retrospective analyses over 24 years within a longitudinal study. SETTING: Population-based sample. Subjects. Eighty-one women. MAIN OUTCOME MEASURES: CSF/S albumin ratio. RESULTS: The CSF/S albumin ratio measured at age 70-84 years was higher amongst women who were overweight or obese (6.50 +/- 2.79 vs. 5.23 +/- 1.61, age-adjusted P = 0.012), and was inversely correlated with SHBG (age-adjusted r = -0.321, P < 0.005) at age 46-60 years. In stepwise regression models, SHBG predicted the CSF/S albumin ratio (beta = -0.017, R2 = 0.107, P = 0.007). The best model (R2 = 0.187) predicting CSF/S albumin ratio included SHBG, age group (age 46 years versus >46), overweight or obesity, and an age group by SHBG interaction. CONCLUSIONS: Lower levels of SHBG in mid-life were related to worse BBB integrity in women after 24 years in late life, even considering other adiposity factors. SHBG may be important for understanding sex hormone-mediated mechanisms in brain health or as an independent marker of adipose tissue, the largest endocrine organ.

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