Obesity with low bone mineral density is a risk for cerebral small-vessel disease in older adults: The Bunkyo Health Study

Obes Res Clin Pract. 2024 Sep-Oct;18(5):363-370. doi: 10.1016/j.orcp.2024.11.006. Epub 2024 Nov 29.

Abstract

Background: Cerebral small-vessel disease (cSVD), a key risk factor for stroke and dementia, has been linked to obesity and low bone mineral density (BMD). While obesity and low BMD are often inversely related, their coexistence may increase cSVD risk. We aimed to assess the prevalence of obesity and low BMD coexistence and its association with increased cSVD prevalence.

Methods: This cross-sectional study used baseline data from the Bunkyo Health Study, which included 1531 community-dwelling adults aged 65-84 years without prior stroke history. All participants underwent dual-energy X-ray absorptiometry and brain magnetic resonance imaging. We defined cSVD as the presence of cerebral lacunar infarcts, cerebral microbleeds, periventricular hyperintensity or deep white matter hyperintensity. Obesity was defined by body mass index. Low BMD was defined as osteoporosis in women and osteopenia/osteoporosis in men. Participants were stratified by sex and classified based on obesity and low BMD presence or absence.

Results: The prevalence of obesity with low BMD was 8.0 % in women and 7.8 % in men. The overall prevalence of cSVD was 23.2 %. Logistic regression analysis revealed that compared to the non-obese and non-low BMD group, the ORs [95 % CIs] for cSVD in the low BMD group, obesity group, and obesity with low BMD group were 1.55 [1.01-2.38], 1.24 [0.66-2.32], and 2.33 [1.20-4.50] in women, and 0.96 [0.60-1.54], 1.13 [0.65-1.96], and 2.80 [1.38-5.69] in men, respectively.

Conclusion: The coexistence of obesity and low BMD, observed in approximately 8 % of older adults, was independently associated with the presence of cSVD.

Keywords: Aging; Cerebral small-vessel disease; Obesity; Osteopenia; Osteoporosis.

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Bone Density*
  • Cerebral Small Vessel Diseases* / diagnostic imaging
  • Cerebral Small Vessel Diseases* / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Japan / epidemiology
  • Magnetic Resonance Imaging
  • Male
  • Obesity* / complications
  • Obesity* / epidemiology
  • Obesity* / physiopathology
  • Osteoporosis* / epidemiology
  • Osteoporosis* / etiology
  • Prevalence
  • Risk Factors