Metabolic pathways associated with cardiometabolic risk effects on cognition in middle-aged adults: the CARDIA study
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Evidence increasingly suggests a connection between cardiovascular disease and brain health in later life; however, the mechanistic pathways from human studies remain unclear. This study aimed to investigate whether urinary metabolites account for part of the association between cognition and cardiometabolic risk.
Methods
Data from 606 participants (aged 48–60; 55% female; 45.5% Black/African American) in the Year 30 follow-up of the Coronary Artery Risk Development in Young Adults Study were analyzed. Urinary metabolites were profiled using nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry; brain magnetic resonance imaging data were available for 281 participants. Structural equation models were used to assess pathways linking cardiometabolic factors to cognitive outcome, with urinary metabolites and brain MRI-derived parameters as mediators.
Results
Fasting glucose showed a negative association with cognition. Valine, isoleucine, leucine, and phenylalanine were positively associated with fasting glucose. Valine and aminoadipic acid also showed positive associations between fasting glucose and cognition, while tryptophan was correlated with both fasting glucose and cognition. Indole-3-acetic acid showed negative associations with systolic blood pressure and fasting glucose. Brain MRI-derived parameters in memory-related medial temporal areas were associated with waist circumference.
Conclusions
Urinary metabolites and brain imaging markers were linked with hyperglycemia, obesity, and cognitive performance, highlighting multimodal biomarkers relevant to global cognitive function in individuals with cardiometabolic risk.
Evidence increasingly suggests a connection between cardiovascular disease and brain health in later life; however, the mechanistic pathways from human studies remain unclear. This study aimed to investigate whether urinary metabolites account for part of the association between cognition and cardiometabolic risk.
Methods
Data from 606 participants (aged 48–60; 55% female; 45.5% Black/African American) in the Year 30 follow-up of the Coronary Artery Risk Development in Young Adults Study were analyzed. Urinary metabolites were profiled using nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry; brain magnetic resonance imaging data were available for 281 participants. Structural equation models were used to assess pathways linking cardiometabolic factors to cognitive outcome, with urinary metabolites and brain MRI-derived parameters as mediators.
Results
Fasting glucose showed a negative association with cognition. Valine, isoleucine, leucine, and phenylalanine were positively associated with fasting glucose. Valine and aminoadipic acid also showed positive associations between fasting glucose and cognition, while tryptophan was correlated with both fasting glucose and cognition. Indole-3-acetic acid showed negative associations with systolic blood pressure and fasting glucose. Brain MRI-derived parameters in memory-related medial temporal areas were associated with waist circumference.
Conclusions
Urinary metabolites and brain imaging markers were linked with hyperglycemia, obesity, and cognitive performance, highlighting multimodal biomarkers relevant to global cognitive function in individuals with cardiometabolic risk.
Date Issued
2026-08-01
Date Acceptance
2026-04-25
Citation
Metabolomics, 2026, 22 (4)
ISSN
1573-3882
Publisher
Springer
Journal / Book Title
Metabolomics
Volume
22
Issue
4
Copyright Statement
© The Author(s) 2026 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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Publication Status
Published
Article Number
99
Date Publish Online
2026-06-17