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Objective <p>This study aims to investigate alterations in glymphatic system (GS) function in patients with non-alcoholic fatty liver disease (NAFLD) and explore the relationship of these alterations with cognition and clinical indicators.</p> Materials and methods <p>In this cross-sectional study, forty-three patients with pre-cirrhotic NAFLD (male: 37, mean age: 38.2 ± 6.7 years) and twenty-three age-, sex-, and education-matched controls (male: 17, mean age: 41.0 ± 6.7 years) underwent diffusion tensor imaging (DTI) examination and cognitive measurements. The DTI analysis along the perivascular space (DTI-ALPS) index, calculated from the DTI data, assessed differences in GS function between the two groups. Linear regression analysis examined the relationship between the ALPS index and Z-transformed cognitive scores. Spearman/Pearson correlation analysis was conducted for assessing the relationship of the ALPS index with clinical indicators.</p> Results <p>After adjusted for age, sex, and BMI, NAFLD patients exhibited significantly lower ALPS index and higher diffusivity of projection fibers in the direction of the y-axis than controls (both <i>P</i> &lt; 0.001). In the NAFLD group, the ALPS index was significantly correlated with the Mini-Mental State Examination score (beta [95% CI] = 2.123 [0.156, 4.091], <i>P</i> = 0.035) and the clock drawing score (beta [95% CI] = 4.233 [0.073, 8.393], <i>P</i> = 0.046) after adjusting for age, sex, body mass index, and education level. In addition, there was a significantly positive correlation between the ALPS index and abdominal visceral adipose tissue area (<i>r</i> = 0.353, <i>P</i> = 0.020) after adjusting for age, sex, and BMI in NAFLD patients.</p> Conclusion <p>NAFLD patients without cirrhosis showed significantly a reduced ALPS index compare to matched controls, indicating potential alterations in GS function. These alterations correlated with cognitive performance and clinical indicators, implying a possible link between GS function and cognitive performance in NAFLD that requires longitudinal validation.</p>

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Glymphatic alteration in NAFLD patient: a preliminary magnetic resonance imaging study based on DTI-ALPS

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月10日

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  • Kun Shu,
  • Shaoqing Chen,
  • Shuang Meng,
  • Yang Yang,
  • Jiawen Song,
  • Xiaoyan Huang,
  • Xinjian Ye,
  • Shihan Cui,
  • Yongjin Zhou,
  • Lu Han,
  • Peng Wu,
  • Zhihan Yan,
  • Kun Liu

摘要

Objective

This study aims to investigate alterations in glymphatic system (GS) function in patients with non-alcoholic fatty liver disease (NAFLD) and explore the relationship of these alterations with cognition and clinical indicators.

Materials and methods

In this cross-sectional study, forty-three patients with pre-cirrhotic NAFLD (male: 37, mean age: 38.2 ± 6.7 years) and twenty-three age-, sex-, and education-matched controls (male: 17, mean age: 41.0 ± 6.7 years) underwent diffusion tensor imaging (DTI) examination and cognitive measurements. The DTI analysis along the perivascular space (DTI-ALPS) index, calculated from the DTI data, assessed differences in GS function between the two groups. Linear regression analysis examined the relationship between the ALPS index and Z-transformed cognitive scores. Spearman/Pearson correlation analysis was conducted for assessing the relationship of the ALPS index with clinical indicators.

Results

After adjusted for age, sex, and BMI, NAFLD patients exhibited significantly lower ALPS index and higher diffusivity of projection fibers in the direction of the y-axis than controls (both P < 0.001). In the NAFLD group, the ALPS index was significantly correlated with the Mini-Mental State Examination score (beta [95% CI] = 2.123 [0.156, 4.091], P = 0.035) and the clock drawing score (beta [95% CI] = 4.233 [0.073, 8.393], P = 0.046) after adjusting for age, sex, body mass index, and education level. In addition, there was a significantly positive correlation between the ALPS index and abdominal visceral adipose tissue area (r = 0.353, P = 0.020) after adjusting for age, sex, and BMI in NAFLD patients.

Conclusion

NAFLD patients without cirrhosis showed significantly a reduced ALPS index compare to matched controls, indicating potential alterations in GS function. These alterations correlated with cognitive performance and clinical indicators, implying a possible link between GS function and cognitive performance in NAFLD that requires longitudinal validation.