Key result
Higher regional and ectopic adiposity links to lower cerebral blood flow in older adults.
Why the study?
Obesity is associated with lower cerebral blood flow, but whether regional and ectopic fat depots are associated with cerebral blood flow is unclear.
Is increased regional and ectopic adiposity associated with lower cerebral blood flow in older adults?
Cross-Sectional (n=23)
Is increased regional and ectopic adiposity associated with lower cerebral blood flow in older adults?
Mean Difference: -2.31 (95% CI -3.87–-0.76)
Increased regional and ectopic adiposity is associated with lower cerebral blood flow in older adults, suggesting fat distribution may be a marker of brain health.
Ectopic adiposity was associated with lower cerebral blood flow in older adults; hypothesis-generating and requires prospective validation before clinical consideration.
Introduction and Objective: Cerebral blood flow (CBF) is the volume of blood delivered to brain tissue, measured in the units of ml blood delivered to 100g tissue per minute (ml/100g/min). Lower CBF in certain regions is associated with cognitive decline and dementia risk. Obesity is associated with lower CBF, but whether regional and ectopic fat depots are associated with CBF is unclear. We examined associations between MRI-derived body composition and regional CBF in older adults with and without type 2 diabetes (T2D). Methods: This cross-sectional study included 23 adults ages 55-85 years (T2D n=12). The mDixon fat and water MRI scans quantified liver fat fraction (%), visceral adipose tissue (VAT, L), abdominal subcutaneous adipose tissue (ASAT, L), total adipose tissue (TAT, L), total lean tissue (TLT, L), and thigh muscle fat (%). CBF was measured by arterial spin labeling MRI without contrast agent and averaged across voxelwise-defined regional clusters. Linear regression estimated mean difference (MD) in CBF per 1% (liver fat) or 1-L (volumes) higher measure, adjusting for age and sex; T2D interaction was tested and secondary models additionally adjusted for T2D. Results: Mean age was 68.6 years and 61% were female; cluster CBF was lower in participants with T2D vs controls (31.2 vs 52.7). In age/sex-adjusted models, higher liver fat (MD -2.31; 95% CI -3.87 to -0.76), VAT (MD -3.54; -6.38 to -0.69), ASAT (MD -1.89; -3.26 to -0.52), TAT (MD -0.93; -1.60 to -0.27), TLT (MD -2.49; -4.67 to -0.31), muscle fat (MD -2.21; -6.50 to 2.08) were associated with lower CBF, although muscle fat did not reach statistical significance. These associations did not differ by T2D (interaction P>0.05), but after adjustment for T2D, associations attenuated. Conclusion: In this pilot sample, increased regional and ectopic adiposity was associated with lower CBF, supporting fat distribution as a clinically relevant marker of brain health in aging. Larger studies should clarify independence from T2D and relevance to cognitive outcomes. Disclosure S. Jang: None. M.N. Elsharydah: None. J. Leary: None. A. Jin: None. J. Almandoz: Consultant; Current; AbbVie Inc., Amgen Inc., Boehringer Ingelheim International GmbH, Eli Lilly and Company, Kailera, Novo Nordisk, Metsera, Rhythm Pharmaceuticals, Inc., Rivus. B.P. Thomas: None. Funding National Institutes of Health (P30 DK127984), Cancer Prevention and Research Institute of Texas (RR180056)
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Jang et al. (2026) conducted a cross-sectional in Older adults with and without type 2 diabetes (n=23). Regional and ectopic adiposity (e.g., liver fat, visceral adipose tissue) vs. Lower adiposity was evaluated on Cerebral blood flow (CBF) (MD -2.31, 95% CI -3.87 to -0.76). Increased regional and ectopic adiposity, including higher liver fat (MD -2.31; 95% CI -3.87 to -0.76), was associated with lower cerebral blood flow in older adults.
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