Lipid-Related Metabolic Dysregulation Affects Survival in Idiopathic Normal Pressure Hydrocephalus.

Authors

Jacopo Bissacco, Davide Mascioli, Clara Simonetta, Maria Mancini, Veronica Buttarazzi, Matteo Conti, Federica Veltri, Silvio Bagetta, Mariangela Pierantozzi, Alessandro Stefani, Fabio Buttari, Diego Centonze, Alessandro Pesce, Massimo Pieri, Stefano Borrelli, Francesca Di Giuliano, Tommaso Schirinzi

Published in

Movement disorders clinical practice. Sep 09, 2026. Epub Sep 09, 2026.

Abstract

Idiopathic normal pressure hydrocephalus (iNPH) is associated with increased mortality and vascular-metabolic comorbidity, but prognostic biomarkers are lacking.
To assess the triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) ratio, an insulin resistance (IR) marker, and its associations with MRI glymphatic markers and mortality in iNPH.
We conducted a dual-center longitudinal study including 67 iNPH patients and 37 matched controls. Baseline lipid profiles were assessed, enlarged perivascular spaces (EPVS) were rated on 3 T MRI in a subgroup, differences were tested by ANCOVA, and mortality associations by adjusted Cox models.
iNPH patients showed higher triglycerides and TG/HDL-C and lower HDL-C. High-grade centrum semiovale (CSO)-EPVS were associated with higher TG/HDL-C. TG/HDL-C showed the strongest mortality association. A model combining TG/HDL-C with CSO-EPVS showed the best fit, suggesting synergy.
iNPH exhibits a lipid profile associated with IR linked to glymphatic alterations and mortality. Moreover, despite requiring large-scale validation, combined-marker models are promising.

PMID:
42717528
Bibliographic data and abstract were imported from PubMed on 10 Sep 2026.

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