Presećki Paola, Mück-Seler Dorotea, Mimica Ninoslav, Pivac Nela, Mustapić Maja, Stipcević Tamara, Smalc Vera Folnegović
Sveti Ivan Psychiatric Hospital, Jankomir, Zagreb, Croatia.
Coll Antropol. 2011 Jan;35 Suppl 1:115-20.
The role of lipids in the aetiology and progress of Alzheimer's disease (AD) is still unclear High lipid levels could be one of the risk factors for AD, but no association or even protective effects of high cholesterol levels in the development of the AD were also found. The aim of the study was to determine serum levels of total cholesterol, high-density-lipoprotein cholesterol (HDL-C), low-density-lipoprotein cholesterol (LDL-C) and triglycerides (TG) in female patients with AD and in healthy elderly controls. The 50 patients met the diagnostic criteria of probable AD according to the NINDS-ADRDA and DSM-IV criteria. Cognitive impairment was evaluated using the Mini Mental State Examination (MMSE). Patients were subdivided into two groups of 19 patients in the middle (MMSE 10-19) and 31 patients in the late (MMSE 0-9) phase ofAD. Psychotic and non-psychotic features, evaluated by means of Neuropsychiatric Inventory, were presented in 13 and 37patients with AD, respectively. Control group consisted of 58 subjects without cognitive impairment (MMSE >27) and with lipid levels within normal range. Serum lipid levels were determined by the enzymatic colour tests and by the enzymatic clearance assay. Significantly lower lipid levels were found in patients with AD, than in controls. Patients in the late phase of AD had significantly lower entire lipid profile than controls and significantly lower cholesterol and LDL-C levels than patients in the middle stage ofAD. There was no difference in lipid levels between patients with and without psychotic features. The significant positive correlations were found between MMSE scores and cholesterol, LDL-C levels and age in all AD patients. The results support the presumption that lipid profile might be connected with the aetiology and progress of AD and showed the association between low serum cholesterol and LDL-C levels and cognitive decline in patients with AD. Further studies are needed to confirm the relationship between lipid levels and cognition, and to validate the lipid profile as a biological marker for the progress of AD.
脂质在阿尔茨海默病(AD)病因及进展中的作用仍不明确。高血脂水平可能是AD的危险因素之一,但也有研究未发现高胆固醇水平与AD发病之间存在关联,甚至发现其具有保护作用。本研究旨在测定AD女性患者及健康老年对照者的血清总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和甘油三酯(TG)水平。50例患者符合美国国立神经疾病与中风研究所-阿尔茨海默病及相关疾病协会(NINDS-ADRDA)和《精神疾病诊断与统计手册》第四版(DSM-IV)标准中可能AD的诊断标准。使用简易精神状态检查表(MMSE)评估认知障碍。患者被分为两组,19例处于AD中期(MMSE 10 - 19),31例处于AD晚期(MMSE 0 - 9)。分别有13例和37例AD患者具有通过神经精神科量表评估的精神病性和非精神病性特征。对照组由58名无认知障碍(MMSE >27)且血脂水平在正常范围内的受试者组成。通过酶比色法和酶清除法测定血清脂质水平。发现AD患者的脂质水平显著低于对照组。AD晚期患者的整体脂质谱显著低于对照组,且胆固醇和LDL-C水平显著低于AD中期患者。有或无精神病性特征的患者脂质水平无差异。在所有AD患者中,MMSE评分与胆固醇、LDL-C水平及年龄之间存在显著正相关。结果支持脂质谱可能与AD病因及进展相关的推测,并显示低血清胆固醇和LDL-C水平与AD患者认知功能下降之间存在关联。需要进一步研究以证实脂质水平与认知之间的关系,并验证脂质谱作为AD进展的生物学标志物。