No Amyloid Accumulation Without Metabolic Syndrome
Dementia Prevention Possible Through Lifestyle Correction
It was found that if a person has a body mass index (BMI) of 25 kg/㎡ or higher and is classified as healthy obese?meaning they have none or only one metabolic disorder that meets the diagnostic criteria for metabolic syndrome?the likelihood of developing Alzheimer's disease is lower.
A joint research team led by Professor Kang Seong-hoon of the Department of Neurology at Korea University Guro Hospital and Professor Seo Sang-won of the Department of Neurology at Samsung Seoul Hospital revealed on the 11th the results of a study clarifying the effects of body weight and metabolic syndrome on the accumulation of causative substances of Alzheimer's disease and its progression. Although the relationship between body weight and Alzheimer's disease markers was well known, there had been no study that comprehensively considered metabolic syndrome, which is closely related to obesity, to confirm its impact on Alzheimer's disease markers.
The research team aimed to examine the effects of body weight status on Alzheimer's disease and vascular dementia brain imaging biomarkers according to the presence of metabolic syndrome and to analyze the impact of these relationships on cognitive decline. They classified 1,736 Koreans aged 45 and older without dementia into underweight (BMI below 18.5), normal weight, and obese groups (BMI 25 or higher) based on BMI. Each group was further subdivided into metabolically healthy and metabolic syndrome groups according to metabolic syndrome criteria. They analyzed amyloid PET, brain MRI, and cognitive function test results of these groups. The metabolically healthy group was defined as having one or fewer metabolic syndrome diagnostic criteria (hypertension, high fasting blood glucose, high triglycerides, low HDL cholesterol), excluding waist circumference.
As a result, the positive rate of amyloid beta protein, which indicates the risk of amyloid accumulation?a causative substance of Alzheimer's disease?was higher in the underweight group (73.9%) and lower in the obese group (37.0%), suggesting that obesity reduces amyloid accumulation. Furthermore, when subdivided by the presence of metabolic syndrome, the positive rates of amyloid beta protein in the metabolically healthy obese group and the metabolic syndrome obese group were 29.6% and 42.5%, respectively, indicating that the protective effect of obesity against amyloid accumulation was only valid when metabolically healthy. The metabolically healthy obese group had a thicker hippocampal volume and higher cognitive function scores, and during long-term follow-up, their rate of cognitive decline was the slowest.
Professor Kang stated, "This study confirmed that the presence or absence of metabolic syndrome influences the relationship between body weight and Alzheimer's markers," adding, "Considering that body weight and metabolic syndrome can be corrected through diet, exercise, and medication, maintaining metabolic health and an appropriate body weight could contribute to preventing Alzheimer's disease-related dementia." He also added, "Based on these research results, by accompanying appropriate lifestyle modifications, it will be possible to maximize the therapeutic effects of the Alzheimer's disease preventive drugs to be introduced domestically by the end of this year."
This research paper was published in the recent issue of the well-known Alzheimer's disease-related academic journal, Alzheimer's Research & Therapy.
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