Bowman Gene L, Kaye Jeffrey A, Quinn Joseph F
Department of Neurology, Oregon Health and Science University, 3181 Southwest Samuel Jackson Park Road, Portland, OR 97239, USA.
Curr Gerontol Geriatr Res. 2012;2012:184042. doi: 10.1155/2012/184042. Epub 2012 May 13.
Background. Blood-brain barrier (BBB) dysfunction may have a significant role in the pathogenesis of Alzheimer's disease (AD). Modifiable factors associated with BBB function may have therapeutic implication. This study tested the hypothesis that dyslipidemia is associated with BBB impairment in mild-to-moderate AD. Methods. Thirty-six subjects with AD were followed for 1 year. Fasting CSF and plasma were collected with clinical assessments at baseline and 12 months. BBB impairment was defined as CSF albumin index ≥9. Independent t-tests and linear regression assessed the relationship between plasma lipoproteins and BBB integrity. Results. Dyslipidemia was prevalent in 47% of the population, and in 75% of those with BBB impairment. Subjects with BBB impairment had significantly higher mean plasma triglyceride and lower HDL cholesterol (TG, P = 0.007; HDL, P = 0.043). Plasma triglycerides explained 22% of the variance in BBB integrity and remained significant after controlling for age, gender, ApoE-4 genotype, blood pressure, and statin use. Conclusion. Dyslipidemia is more prevalent in AD subjects with BBB impairment. Plasma triglyceride and HDL cholesterol may have a role in maintaining BBB integrity in mild-to-moderate Alzheimer's disease.
背景。血脑屏障（BBB）功能障碍可能在阿尔茨海默病（AD）的发病机制中起重要作用。与血脑屏障功能相关的可改变因素可能具有治疗意义。本研究检验了血脂异常与轻至中度AD患者血脑屏障损伤相关的假设。方法。36名AD患者随访1年。在基线和12个月时收集空腹脑脊液和血浆，并进行临床评估。血脑屏障损伤定义为脑脊液白蛋白指数≥9。采用独立样本t检验和线性回归评估血浆脂蛋白与血脑屏障完整性之间的关系。结果。47%的研究对象存在血脂异常，在血脑屏障损伤患者中这一比例为75%。血脑屏障损伤患者的平均血浆甘油三酯显著升高，高密度脂蛋白胆固醇降低（甘油三酯，P = 0.007；高密度脂蛋白，P = 0.043）。血浆甘油三酯可解释血脑屏障完整性22%的变异，在控制年龄、性别、载脂蛋白E-4基因型、血压和他汀类药物使用后仍具有显著性。结论。血脂异常在血脑屏障损伤的AD患者中更为普遍。血浆甘油三酯和高密度脂蛋白胆固醇可能在维持轻至中度阿尔茨海默病患者血脑屏障完整性方面发挥作用。
