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Golan Shekhtman S, Boccara E, Ravona-Springer R, Inbar Y, Zelicha H, Livny A, Bendlin BB, Lesman-Segev O, Yore I, Heymann A, Sano M, Mardor Y, Azuri J, Schnaider Beeri M. Abdominal fat depots are related to lower cognitive functioning and brain volumes in middle-aged males at high Alzheimer's risk. Obesity (Silver Spring) 2024; 32:1009-1022. [PMID: 38410053 DOI: 10.1002/oby.24004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 12/24/2023] [Accepted: 01/07/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE High BMI, which poorly represents specific fat depots, is linked to poorer cognition and higher dementia risk, with different associations between sexes. This study examined associations of abdominal fat depots with cognition and brain volumes and whether sex modifies this association. METHODS A total of 204 healthy middle-aged offspring of Alzheimer's dementia patients (mean age = 59.44, 60% females) underwent abdominal magnetic resonance imaging to quantify hepatic, pancreatic, visceral, and subcutaneous adipose tissue and to assess cognition and brain volumes. RESULTS In the whole sample, higher hepatic fat percentage was associated with lower total gray matter volume (β = -0.17, p < 0.01). Primarily in males, higher pancreatic fat percentage was associated with lower global cognition (males: β = -0.27, p = 0.03; females: β = 0.01, p = 0.93) executive function (males: β = -0.27, p = 0.03; females: β = 0.02, p = 0.87), episodic memory (males: β = -0.28, p = 0.03; females: β = 0.07, p = 0.48), and inferior frontal gyrus volume (males: β = -0.28, p = 0.02; females: β = 0.10, p = 0.33). Visceral and subcutaneous adipose tissue was inversely associated with middle frontal and superior frontal gyrus volumes in males and females. CONCLUSIONS In middle-aged males at high Alzheimer's dementia risk, but not in females, higher pancreatic fat was associated with lower cognition and brain volumes. These findings suggest a potential sex-specific link between distinct abdominal fat with brain health.
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Affiliation(s)
- Sapir Golan Shekhtman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
| | - Ethel Boccara
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Ramit Ravona-Springer
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
- Memory Clinic, Sheba Medical Center, Tel HaShomer, Israel
| | - Yael Inbar
- Department of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
| | - Hila Zelicha
- The Health & Nutrition Innovative International Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Abigail Livny
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
- Department of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
- The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Barbara B Bendlin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Orit Lesman-Segev
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
- Department of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
| | - Iscka Yore
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
| | | | - Mary Sano
- Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yael Mardor
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
| | - Joseph Azuri
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Maccabi Healthcare Services, Tel Aviv, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Boccara E, Golan S, Beeri MS. The association between regional adiposity, cognitive function, and dementia-related brain changes: a systematic review. Front Med (Lausanne) 2023; 10:1160426. [PMID: 37457589 PMCID: PMC10349176 DOI: 10.3389/fmed.2023.1160426] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/15/2023] [Indexed: 07/18/2023] Open
Abstract
Background Adiposity has been previously associated with cognitive impairment and Alzheimer's disease and related disorders (ADRD). Body mass index (BMI) is the most common measure of global adiposity, but inconsistent results were found since it is a global measurement. BMI does not represent regional fat distribution which differs between sexes, race, and age. Regional fat distribution may contribute differently to cognitive decline and Alzheimer's disease (AD)-related brain changes. Fat-specific targeted therapies could lead to personalized improvement of cognition. The goal of this systematic review is to explore whether regional fat depots, rather than central obesity, should be used to understand the mechanism underlying the association between adiposity and brain. Methods This systematic review included 33 studies in the English language, conducted in humans aged 18 years and over with assessment of regional adiposity, cognitive function, dementia, and brain measures. We included only studies that have assessed regional adiposity using imaging technics and excluded studies that were review articles, abstract only or letters to editor. Studies on children and adolescents, animal studies, and studies of patients with gastrointestinal diseases were excluded. PubMed, PsychInfo and web of science were used as electronic databases for literature search until November 2022. Results Based on the currently available literature, the findings suggest that different regional fat depots are likely associated with increased risk of cognitive impairment, brain changes and dementia, especially AD. However, different regional fat depots can have different cognitive outcomes and affect the brain differently. Visceral adipose tissue (VAT) was the most studied regional fat, along with liver fat through non-alcoholic fatty liver disease (NAFLD). Pancreatic fat was the least studied regional fat. Conclusion Regional adiposity, which is modifiable, may explain discrepancies in associations of global adiposity, brain, and cognition. Specific regional fat depots lead to abnormal secretion of adipose factors which in turn may penetrate the blood brain barrier leading to brain damage and to cognitive decline.
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Affiliation(s)
- Ethel Boccara
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
| | - Sapir Golan
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Beeri MS, Tirosh A, Lin H, Golan S, Boccara E, Sano M, Zhu CW. Stability in BMI over time is associated with a better cognitive trajectory in older adults. Alzheimers Dement 2022; 18:2131-2139. [PMID: 35049119 PMCID: PMC9296696 DOI: 10.1002/alz.12525] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Evidence on simultaneous changes in body mass index (BMI) and cognitive decline, which better reflect the natural course of both health phenomena, is limited. METHODS We capitalized on longitudinal data from 15,977 initially non-demented elderly from the Alzheimer's Disease Centers followed for 5 years on average. Changes in BMI were defined as (1) last minus first BMI, (2) mean of all follow-up BMIs minus first BMI, and (3) standard deviation of BMI change from baseline and all follow-up visits (representing variability). RESULTS Participants with significant changes in BMI (increase or decrease of ≥5%), or who had greater variability in BMI, had faster cognitive decline. This pattern was consistent irrespective of normal (BMI < 25; N = 5747), overweight (25 ≤ BMI < 30; N = 6302), or obese (BMI ≥ 30; N = 3928) BMI at baseline. CONCLUSIONS Stability in BMI predicts better cognitive trajectories suggesting clinical value in tracking BMI change, which is simple to measure, and may point to individuals whose cognition is declining.
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Affiliation(s)
- Michal Schnaider Beeri
- Department of PsychiatryThe Icahn School of Medicine at Mount SinaiNew YorkUSA,The Joseph Sagol Neuroscience CenterSheba Medical CenterRamat GanIsrael
| | - Amir Tirosh
- Division of EndocrinologyDiabetes and MetabolismSheba Medical CenterRamat GanIsrael
| | - Hung‐Mo Lin
- Department of Health Population Sciences and PolicyCenter of BiostatisticsIcahn School of MedicineMount SinaiUSA
| | - Sapir Golan
- The Joseph Sagol Neuroscience CenterSheba Medical CenterRamat GanIsrael
| | - Ethel Boccara
- The Joseph Sagol Neuroscience CenterSheba Medical CenterRamat GanIsrael
| | - Mary Sano
- Department of PsychiatryThe Icahn School of Medicine at Mount SinaiNew YorkUSA,GRECCJames J Peters VA Medical CenterBronxNew YorkUSA
| | - Carolyn W. Zhu
- Brookdale Department of Geriatrics and Palliative MedicineIcahn School of MedicineMount SinaiUSA,GRECCJames J Peters VA Medical CenterBronxNew YorkUSA
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West RK, Ravona‐Springer R, Sharvit‐Ginon I, Ganmore I, Manzali S, Tirosh A, Golan S, Boccara E, Heymann A, Beeri MS. Long-term trajectories and current BMI are associated with poorer cognitive functioning in middle-aged adults at high Alzheimer's disease risk. Alzheimers Dement (Amst) 2021; 13:e12247. [PMID: 35005193 PMCID: PMC8719431 DOI: 10.1002/dad2.12247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/16/2021] [Accepted: 08/31/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION We examined relationships of body mass index (BMI) with cognition in middle-aged adults at Alzheimer's disease (AD) risk due to parental family history. METHODS Participants are offspring of AD patients from the Israel Registry of Alzheimer's Prevention (N = 271). Linear regressions assessed associations of BMI and cognition, and whether associations differed by maternal/paternal history. Analyses of covariance examined associations of long-term trajectories of BMI with cognition. RESULTS Higher BMI was associated with worse language (P = .045). Interactions of BMI with parental history were significant for episodic memory (P = .023), language (p = .027), working memory (P = .006), global cognition (P = .008); associations were stronger among participants with maternal history. Interactions of BMI trajectories with parental history were significant for episodic memory (P = .017), language (P = .013), working memory (P = .001), global cognition (P = .005), with stronger associations for maternal history. DISCUSSION Higher BMI and overweight/obese trajectories were associated with poorer cognition in adults with maternal history of AD, but not those with paternal history.
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Affiliation(s)
- Rebecca K. West
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Ramit Ravona‐Springer
- The Joseph Sagol Neuroscience CenterSheba Medical CenterTel‐HashomerIsrael
- Department of PsychiatrySheba Medical CenterTel‐HashomerIsrael
- Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
| | | | - Ithamar Ganmore
- The Joseph Sagol Neuroscience CenterSheba Medical CenterTel‐HashomerIsrael
| | - Sigalit Manzali
- The Joseph Sagol Neuroscience CenterSheba Medical CenterTel‐HashomerIsrael
- Department of PsychiatrySheba Medical CenterTel‐HashomerIsrael
| | - Amir Tirosh
- Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
- Institute of EndocrinologySheba Medical CenterTel HashomerIsrael
| | - Sapir Golan
- The Joseph Sagol Neuroscience CenterSheba Medical CenterTel‐HashomerIsrael
- Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
| | - Ethel Boccara
- The Joseph Sagol Neuroscience CenterSheba Medical CenterTel‐HashomerIsrael
- Bar‐Ilan UniversityRamat GanIsrael
| | - Anthony Heymann
- Maccabi Healthcare ServicesTel AvivIsrael
- Department of Family MedicineTel Aviv UniversityTel AvivIsrael
| | - Michal Schnaider Beeri
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- The Joseph Sagol Neuroscience CenterSheba Medical CenterTel‐HashomerIsrael
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Boccara E, Golan S, Ravona‐Springer R, Inbar Y, Yore I, Heymann A, Beeri MS. The relationship of regional abdominal adiposity and adiposity‐related factors with cognitive functioning among middle‐aged individuals at high Alzheimer’s dementia risk. Alzheimers Dement 2021. [DOI: 10.1002/alz.052777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ethel Boccara
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
- Bar‐Ilan University Ramat Gan Israel
| | - Sapir Golan
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
- Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
| | - Ramit Ravona‐Springer
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
| | - Yael Inbar
- Department of Diagnostic Imaging, Sheba Medical Center Ramat Gan Israel
| | - Iscka Yore
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
| | | | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
- Icahn School of Medicine at Mount Sinai New York NY USA
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Golan S, Boccara E, Ravona‐Springer R, Inbar Y, Livny A, Yore I, Heymann A, Beeri MS. Regional abdominal adiposity and related factors are associated with brain volumes and cognitive functioning in middle‐aged adults at high AD‐risk. Alzheimers Dement 2021. [DOI: 10.1002/alz.058387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sapir Golan
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- The Joseph Sagol Neuroscience Center Sheba Medical Center Tel Hashomer Ramat Gan Israel
| | - Ethel Boccara
- The Joseph Sagol Neuroscience Center Sheba Medical Center Tel Hashomer Ramat Gan Israel
- Bar‐Ilan University Ramat Gan Israel
| | - Ramit Ravona‐Springer
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- The Joseph Sagol Neuroscience Center Sheba Medical Center Tel Hashomer Ramat Gan Israel
- Sheba Medical Center Memory clinic Sheba Medical Center Ramat Gan Israel
- Memory clinic Sheba Medical Center Tel Hashomer Ramat‐Gan Israel
| | - Yael Inbar
- Department of Diagnostic Imaging Sheba Medical Center Tel Hashomer Ramat Gan Israel
| | - Abigail Livny
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- The Joseph Sagol Neuroscience Center Sheba Medical Center Tel Hashomer Ramat Gan Israel
- Department of Diagnostic Imaging Sheba Medical Center Tel Hashomer Ramat Gan Israel
| | - Iscka Yore
- The Joseph Sagol Neuroscience Center Sheba Medical Center Tel Hashomer Ramat Gan Israel
| | | | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center Sheba Medical Center Tel Hashomer Ramat Gan Israel
- Icahn School of Medicine at Mount Sinai New York NY USA
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Beeri MS, Tirosh A, Lin H, Golan S, Boccara E, Sano M, Zhu CW. Stability in BMI over time is associated with a better cognitive trajectory in older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.057574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Michal Schnaider Beeri
- Icahn School of Medicine at Mount Sinai New York NY USA
- Sheba Medical Center Tel Hashomer Israel
| | | | - HungMo Lin
- Icahn School of Medicine at Mount Sinai New York NY USA
| | | | | | - Mary Sano
- Icahn School of Medicine at Mount Sinai New York NY USA
- James J. Peters VA Medical Center Bronx NY USA
| | - Carolyn W Zhu
- Icahn School of Medicine at Mount Sinai New York NY USA
- James J. Peters VA Medical Center Bronx NY USA
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Golan S, Boccara E, Ravona‐Springer R, Inbar Y, Yore I, Heymann A, Beeri MS. Regional abdominal adiposity is associated with BMI‐related brain regions in middle‐aged adults at high risk of Alzheimer’s dementia. Alzheimers Dement 2021. [DOI: 10.1002/alz.052080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sapir Golan
- Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
| | - Ethel Boccara
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
- Bar‐Ilan University Ramat Gan Israel
| | - Ramit Ravona‐Springer
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
| | - Yael Inbar
- Department of Diagnostic Imaging, Sheba Medical Center Ramat Gan Israel
| | - Iscka Yore
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
| | | | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer Ramat Gan Israel
- Icahn School of Medicine at Mount Sinai New York NY USA
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Abstract
The aim of this study was to place into perspective some factors that played an important role in the healing of periapical lesions after surgical endodontic procedures. Root-ends were sectioned at different angulations on models and analyzed by photoelastimetry. Results showed that a section of the root-end through a plane perpendicular to the long axis of the tooth offers a better distribution of the stresses exerted on the apical region that the use of an inclined plane. The biological implications of these results have led the authors to propose a plan of resection that is perpendicular to the long axis of the tooth instead of the inclined plane commonly used.
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Affiliation(s)
- G Sauveur
- UFR d'Odontologie Université, Paris, France
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Boccara E, Colon P, Picard B, Ogolnik R. [Mechanical properties of composite resins: changes over time]. J Biomater Dent 1985; 1:111, 151-9. [PMID: 3915990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Boccara E. [Advantages of the wax-up technique in the dimensional stability of prosthetic models]. Cah Prothese 1984; 12:121-129. [PMID: 6372953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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