Association Between Visceral Fat and Brain Cortical Thickness in the Elderly: A Neuroimaging Study

Background: Despite emerging evidence suggesting that visceral fat may play a major role in obesity-induced neurodegeneration, little evidence exists on the association between visceral fat and brain cortical thickness in the elderly.

Purpose: We aimed to examine the association between abdominal fat and brain cortical thickness in a Korean elderly population.

Methods: This cross-sectional study included elderly individuals without dementia (n = 316). Areas of visceral fat and subcutaneous fat (cm²) were estimated from computed tomography scans. Regional cortical thicknesses (mm) were obtained by analyzing brain magnetic resonance images. Given the inverted U-shaped relationship between visceral fat area and global cortical thickness (examined using a generalized additive model), visceral fat area was categorized into quintiles, with the middle quintile being the reference group. A generalized linear model was built to explore brain regions associated with visceral fat. The same approach was used for subcutaneous fat.

Results: The mean (standard deviation) age was 67.6 (5.0) years. The highest quintile (vs. the middle quintile) group of visceral fat area had reduced cortical thicknesses in the global [β = -0.04 mm, standard error (SE) = 0.02 mm, p = 0.004], parietal (β = -0.04 mm, SE = 0.02 mm, p = 0.01), temporal (β = -0.05 mm, SE = 0.02 mm, p = 0.002), cingulate (β = -0.06 mm, SE = 0.02 mm, p = 0.01), and insula lobes (β = -0.06 mm, SE = 0.03 mm, p = 0.02). None of the regional cortical thicknesses significantly differed between the highest and the middle quintile groups of subcutaneous fat area.

Conclusion: The findings suggest that a high level of visceral fat, but not subcutaneous fat, is associated with a reduced cortical thickness in the elderly.