Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later.
Schindler LS., Subramaniapillai S., Ambikairajah A., Barth C., Crestol A., Voldsbekk I., Beck D., Gurholt TP., Topiwala A., Suri S., Ebmeier KP., Andreassen OA., Draganski B., Westlye LT., de Lange A-MG.
INTRODUCTION: The menopause transition is associated with several cardiometabolic risk factors. Poor cardiometabolic health is further linked to microvascular brain lesions, which can be detected as white matter hyperintensities (WMHs) using T2-FLAIR magnetic resonance imaging (MRI) scans. Females show higher risk for WMHs post-menopause, but it remains unclear whether changes in cardiometabolic risk factors underlie menopause-related increase in brain pathology. METHODS: In this study, we assessed whether cross-sectional measures of cardiometabolic health, including body mass index (BMI) and waist-to-hip ratio (WHR), blood lipids, blood pressure, and long-term blood glucose (HbA1c), as well as longitudinal changes in BMI and WHR, differed according to menopausal status at baseline in 9,882 UK Biobank females (age range 40-70 years, n premenopausal = 3,529, n postmenopausal = 6,353). Furthermore, we examined whether these cardiometabolic factors were associated with WMH outcomes at the follow-up assessment, on average 8.78 years after baseline. RESULTS: Postmenopausal females showed higher levels of baseline blood lipids (HDL β = 0.14, p