摘要
目的分析阿尔茨海默病(AD)疾病谱患者出现精神行为异常症状(BPSD)的潜在生物标志物。方法本研究为前瞻性队列研究,连续性收集2021年1月1日至2022年12月31日首都医科大学附属北京天坛医院阿尔茨海默病生物标志物与生活方式研究队列中的179例AD疾病谱患者为研究对象,根据有无BPSD分为BPSD组(135例)和对照组(44例)。采用假设检验和单因素logistic回归分析两组患者性别、年龄、体重指数、文化程度、疾病诊断、载脂蛋白E等位基因ε4(APOEε4)携带情况,简易精神状态评价量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分情况,以及脑脊液AD相关病理标志物(Aβ42、Aβ40、Aβ42/40、tTau、pTau181)、血清学标志物(白细胞、红细胞、血红蛋白、血小板、总胆红素、白蛋白、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖、红细胞沉降率、同型半胱氨酸、维生素B12、叶酸)指标差异;采用多因素logistic回归分析AD疾病谱患者出现BPSD的潜在生物标志物。结果纳入分析的AD疾病谱患者中,男性77例,女性102例,AD源性轻度认知障碍35例,AD痴呆期144例,年龄(66.54±9.75)岁。BPSD组脑脊液Aβ40和血红蛋白水平均显著低于对照组[7.08(4.42,15.42)比9.62(6.45,12.12)pg/L、(132.70±13.37)比(138.80±14.38)g/L](U=-1.856、t=2.579,均P<0.05)。脑脊液Aβ40水平(OR=0.030,95%CI:0.001~0.760)和血红蛋白水平(OR=0.051,95%CI:0.004~0.670)与AD疾病谱患者出现BPSD呈显著负相关(均P<0.05)。结论脑脊液Aβ40和外周血红蛋白水平下降是AD疾病谱患者出现BPSD的潜在生物标志物。
Objectives To analyze the potential biomarkers of behavioral and psychological symptoms of dementia(BPSD)in patients with Alzheimer′s disease(AD)continuum.Methods A prospective cohort study was consecutively conducted on 179 patients with AD continuum(135 presented with BPSD,44 patients without BPSD as control)from Capital Medical University,Beijing Tiantan Hospital,the Chinese imaging biomarkers and lifestyle cohort between January 1,2021 and December 31,2022.Gender,age,body max index,education level,diagnosis,the apolipoprotein E epsilon4 allele(APOEε4)carrier status,the scores of the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA),cerebrospinal fluid(CSF)AD-related pathological biomarkers(Aβ42,Aβ40,Aβ42/40,tTau,pTau181),and blood biomarkers(white blood cell count,red blood cell count,hemoglobin,platelet,total bilirubin,albumin,total cholesterol,triglyceride,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,fasting glucose,erythrocyte sedimentation rate,homocysteine,vitamin B12,folate)were compared between the two groups by using hypothesis testing and univariate logistic regression analysis.Multivariate logistic regression analysis was used to analyze the potential biomarkers associated with BPSD in patients with AD.Results Among the 179 patients with AD continuum in the final analysis,77 patients were men,102 cases were women;35 patients were identified with mild cognitive impairment(MCI)due to AD and 144 patients with AD dementia stage,the mean age was(66.54±9.75)years.Compared with those in control group,patients with BPSD had lower cerebrospinal fluid(CSF)Aβ40 and blood hemoglobin levels[7.08(4.42,15.42)vs 9.62(6.45,12.12)pg/L,(132.70±13.37)vs(138.80±14.38)g/L](U=-1.856,t=2.579,P<0.05).The levels of CSF Aβ40(OR=0.030,95%CI:0.001-0.760)and blood hemoglobin(OR=0.051,95%CI:0.004-0.670)were independently negatively associated with BPSD in patients with AD continuum(both P<0.05).Conclusion The decreased levels of CSF Aβ40 and blood hemoglobin could be considered as potential biomarkers in detecting BPSD in patients with AD continuum.
作者
姜季委
任琦玮
蒋施瑞
江天琳
杨诗怡
徐俊
Jiang Jiwei;Ren Qiwei;Jiang Shirui;Jiang Tianlin;Yang Shiyi;Xu Jun(Department of Cognitive Neurology,Beijing Tiantan Hospital,Capital Medical University,China National Clinical Research Center for Neurological Diseases,Beijing 100070,China)
出处
《中华健康管理学杂志》
CAS
CSCD
2023年第7期502-507,共6页
Chinese Journal of Health Management
基金
国家重点研发计划(2021YFC2500100,2021YFC2500103)
国家自然科学基金(82071187,81870821)。
