Algotsson A, Winblad B
Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Karolinska University Hospital, SE-141 86 Huddinge, Sweden.
Acta Neurol Scand. 2007 Jun;115(6):403-8. doi: 10.1111/j.1600-0404.2007.00823.x.
To evaluate the integrity of the blood-brain barrier (BBB) in incident Alzheimer's disease (AD).
The mean age of the 157 patients (45% men) was 69.7(9.4) years (range 51-88 years). The patients had undergone a thorough investigation including magnetic resonance imaging or computed tomography of the brain. The cerebrospinal(CSF)/plasma albumin ratio (albumin ratio) was used as a measure of BBB function.
There were gender differences with respect to albumin ratio and plasma creatinine with higher values in men (P < 0.001). 42% of the men and 13% of the women (P < 0.001) had a mild to moderate BBB dysfunction when applying the reference limit of the laboratory (<9.2). Both male gender (P = 0.002) and plasma creatinine (P = 0.009) were independently associated with the albumin ratio when controlling for putative confounders.
The BBB is dysfunctional in a portion of patients with AD, both women and, primarily, men. The dysfunction might influence the clearance of both harmful and beneficial substances across the barrier. Renal function might have an impact on the BBB.
评估初发阿尔茨海默病（AD）患者血脑屏障（BBB）的完整性。
157例患者（45%为男性）的平均年龄为69.7（9.4）岁（范围51 - 88岁）。患者接受了包括脑部磁共振成像或计算机断层扫描在内的全面检查。脑脊液（CSF）/血浆白蛋白比率（白蛋白比率）用作衡量BBB功能的指标。
在白蛋白比率和血浆肌酐方面存在性别差异，男性的值更高（P < 0.001）。当应用实验室参考限值（<9.2）时，42%的男性和13%的女性（P < 0.001）存在轻度至中度BBB功能障碍。在控制潜在混杂因素时，男性性别（P = 0.002）和血浆肌酐（P = 0.009）均与白蛋白比率独立相关。
部分AD患者，包括女性，尤其是男性，存在BBB功能障碍。这种功能障碍可能会影响有害物质和有益物质通过该屏障的清除。肾功能可能对BBB有影响。
