Liver function and Alzheimer's brain pathologies: A longitudinal study: Liver and Alzheimer's pathologies.

IMPORTANCE

The neuropathological links underlying the association between changes in liver function and AD have not yet been clearly elucidated.

OBJECTIVE

We aimed to examine the relationship between liver function markers and longitudinal changes in Alzheimer's disease (AD) core pathologies.

DESIGN

Data from the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease, a longitudinal cohort study initiated in 2014, were utilized.

SETTING

Community and memory clinic setting.

PARTICIPANTS

Three hundred forty-seven older adults.

MAIN OUTCOME AND MEASURES: Participants underwent baseline and 2-year follow-up evaluations, including liver function assessments and various brain imaging techniques, such as amyloid and tau PET, FDG-PET, and MRI). Liver function indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin] were examined as exposure variables.

RESULTS

Higher baseline ALT levels were associated with a greater increase in beta-amyloid deposition over 2 years [β = 0.166, Bonferroni-corrected P (PB) = 0.012], while lower total bilirubin levels were associated with a greater increase in tau deposition over the same period (β = -0.570, PB < 0.001). In contrast, AST alone showed no significant association with changes of AD pathologies.

CONCLUSIONS AND RELEVANCE: The findings suggest a possible link between lower liver function and the accumulation of core AD pathologies in the brain. These results also support the possibility that the liver-brain axis could be a potential target for therapeutic or preventive strategies against AD.