血压变异性对非衰弱及衰弱前期人群脑结构及认知功能的相关性:基于UK Biobank数据库的MRI联合临床指标分析OA
Association of blood pressure variability with brain structure and cognitive function in non-frail and pre-frail populations:analysis of MRI combined with clinical indicators based on the UK Biobank
目的 利用英国生物银行(UK Biobank)数据库探讨访视间收缩压变异性(SBPV)对非衰弱及衰弱前期人群脑结构与认知功能的影响.方法 回顾性纳入UK Biobank中59 087例基线非衰弱及衰弱前期人群的临床与影像资料,计算3次访视的收缩压标准差量化SBPV.根据SBPV的三分位数,将纳入对象分为T1组(低SBPV组,n=5242)、T2组(中SBPV组,n=13 949)和T3组(高SBPV组,n=39 896).通过MRI提取脑结构定量指标,并采用标准化量表评估认知功能.构建多因素回归模型分析SBPV与MRI脑结构特征及认知的相关性,应用限制性立方样条(RCS)分析其非线性关系.结果 多因素回归分析显示,校正混杂因素后,高SBPV与脑结构退行性改变相关.与低SBPV组相比,高SBPV组全脑体积减小(β=-8697.41,95％CI:-10496.65～-6898.17,P<0.001),白质高信号体积增加(β=600.09,95％CI:466.48～733.69,P<0.001).RCS分析显示,SBPV与脑体积指标呈倒U型关系,与白质高信号呈J型关系.认知功能分析表明,SBPV对前瞻记忆、反应时间等维度的影响呈现复杂的非线性特征.结论 在非衰弱及衰弱前期人群中,访视间SBPV升高与脑结构退化及部分认知功能减退密切相关,为维持长时程血压稳定作为早期神经保护的潜在干预靶点提供了客观依据.
Objective To investigate the impact of visit-to-visit systolic blood pressure variability(SBPV)on brain structure and cognitive function among non-frail and pre-frail populations using data from the UK Biobank database.Methods Clinical and neuroimaging data from 59 087 non-frail and pre-frail individuals at baseline were retrospectively collected from the UK Biobank.SBPV was quantified by calculating the standard deviation(SD)of systolic blood pressure measurements across three visits.Based on SBPV tertiles,participants were categorized into three groups:the T1 group(low SBPV,n=5242),the T2 group(moderate SBPV,n=13 949),and the T3 group(high SBPV,n=39 896).Quantitative brain structural metrics were extracted via MRI,and cognitive function was evaluated using standardized assessments.Multivariable regression models were constructed to analyze the associations of SBPV with MRI-derived brain structural features and cognitive function,while restricted cubic splines(RCS)were applied to explore potential non-linear relationships.Results Multivariable regression analysis revealed that,after adjusting for confounding factors,elevated SBPV was significantly associated with degenerative changes in brain structure.Compared with the low SBPV group,the high SBPV group exhibited a significant reduction in total brain volume(β=-8697.41,95％CI:-10496.65--6898.17,P<0.001)and a significant increase in white matter hyperintensity(WMH)volume(β=600.09,95％CI:466.48-733.69,P<0.001).RCS analysis demonstrated an inverted U-shaped relationship between SBPV and brain volume metrics,and a J-shaped relationship with WMH volume.Furthermore,cognitive function analysis indicated that SBPV exerted complex non-linear effects on specific cognitive domains,including prospective memory and reaction time.Conclusion Among non-frail and pre-frail populations,elevated visit-to-visit SBPV is closely associated with brain structural degeneration and partial cognitive decline.These findings provide objective evidence that maintaining long-term blood pressure stability may serve as a potential interventional target for early neuroprotection.
杨珺淇;许哲浩;梁建文
中山大学附属第八医院心血管内科,广东 深圳 510020中山大学孙逸仙纪念医院呼吸内科,广东 广州 510120中山大学附属第八医院心血管内科,广东 深圳 510020
血压变异性脑结构认知功能衰弱前期
blood pressure variabilitybrain structurecognitive functionpre-frailty
《分子影像学杂志》 2026 (4)
417-425,9
国家自然科学基金(82170427)广东省基础与应用基础研究基金(2024A1515013213)深圳市福田区卫生健康系统科研项目(FTWS2023017)Supported by National Natural Science Foundation of China(82170427).
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