American Diabetes Association
MetS_Imaging_and_Cognition_-_Clean_Revised_Electronic_Supplement_-_May_8_2024_-_Diabetes_Care.pdf (437.91 kB)

Association of metabolic syndrome with neuroimaging and cognitive outcomes in the UK Biobank

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posted on 2024-06-19, 00:10 authored by Danial Qureshi, Anya Topiwala, Shehab Uddin Al Abid, Naomi E. Allen, Elżbieta Kuźma, Thomas J. Littlejohns

Objective: Metabolic syndrome (MetS) has been previously linked to dementia. This study examines the association of MetS with neuroimaging and cognition in dementia-free adults, offering insight into the impact of MetS on brain health prior to dementia onset.

Research Design and Methods: We included 37,395 dementia-free adults from the UK Biobank. MetS was defined as ≥3 of the following components: elevated waist-circumference, triglycerides, blood-pressure, HbA1c, or reduced HDL-cholesterol. Multivariable-adjusted linear regression was used to assess associations of MetS with structural neuroimaging and cognitive domains.

Results: MetS was associated with lower total brain (Standardised Beta-coefficient (β): -0.06, 95%CI: -0.08, -0.04), grey matter (β: -0.10, 95%CI: -0.12, -0.08) and hippocampal volumes (Left-β: -0.03, 95%CI: -0.05, -0.01; Right-β: -0.04, 95%CI: -0.07, -0.02), and greater white matter hyperintensities (WMH) volume (β: 0.08, 95%CI: 0.06, 0.11). MetS participants performed poorer on cognitive tests of working memory (β: -0.10, 95%CI: -0.13, -0.07), verbal-declarative memory (β: -0.08, 95%CI: -0.11, -0.05), processing speed (β: -0.06, 95%CI: -0.09, -0.04), verbal and numerical reasoning (β: -0.07, 95%CI: -0.09, -0.04), non-verbal reasoning (β: -0.03, 95%CI: -0.05, -0.01), and on executive function, where higher scores indicated poorer performance (β: 0.05, 95%CI: 0.03, 0.08). An increasing number of MetS components were also associated with lower brain volumes, greater WMH, and poorer cognition across all domains.

Conclusions: MetS was associated poorer brain health in dementia-free adults, characterised by lower brain volumes, greater vascular pathology, and poorer cognition. Further research is necessary to understand whether reversal or improvement of MetS can improve brain health.


This work is supported by a doctoral research grant from the Canadian Institutes of Health Research (CIHR) - Institute of Aging (Priority Announcement – Aging, Funding Reference Number: DAA – 181627), and a scholarship offered by the Nuffield Department of Population Health at the University of Oxford (to DQ). This work was also supported by the Nicolaus and Margrit Langbehn Foundation (to EK). For the purpose of open access, the authors have applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising.