Plasma β-hydroxybutyrate concentration, genetic risk, and the incidence of Alzheimer's disease: A prospective study of 261,933 participants

Clin Nutr. 2025 Mar:46:1-9. doi: 10.1016/j.clnu.2025.01.007. Epub 2025 Jan 7.

Abstract

Background: We investigated whether plasma β-hydroxybutyrate levels, a genetic risk score for Alzheimer's disease, and their interaction are associated with incident Alzheimer's disease.

Methods: Using data from the UK Biobank-a population-based cohort study of adults aged 40-69 years, we assessed associations between baseline plasma β-hydroxybutyrate level, genetic risk score for Alzheimer's disease, and incident Alzheimer's disease. Incident Alzheimer's disease data were collected through linked data from hospital admissions and death registries.

Results: In total, 261,933 adults were included, 1978 of whom developed incident Alzheimer's disease. Plasma β-hydroxybutyrate concentrations were not independently associated with Alzheimer's disease incidence after adjusting for covariates, whereas a higher genetic predisposition was linked to increased Alzheimer's disease incidence. Interactions were observed between plasma β-hydroxybutyrate concentrations and genetic risk for Alzheimer's disease on Alzheimer's disease incidence (P < 0.001).

Conclusions: Further studies are warranted to elucidate the impact of plasma β-hydroxybutyrate status on Alzheimer's disease incidence.

Keywords: Alzheimer’s disease; Interaction; Ketone bodies; Polygenic risk; β-hydroxybutyrate.

MeSH terms

  • 3-Hydroxybutyric Acid* / blood
  • Adult
  • Aged
  • Alzheimer Disease* / blood
  • Alzheimer Disease* / epidemiology
  • Alzheimer Disease* / genetics
  • Cohort Studies
  • Female
  • Genetic Predisposition to Disease*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • United Kingdom / epidemiology

Substances

  • 3-Hydroxybutyric Acid