Hilal Saima, Chai Yuek Ling, Ikram Mohammad Kamran, Elangovan Sakktivel, Yeow Tan Boon, Xin Xu, Chong Jun Yi, Venketasubramanian Narayanaswamy, Richards Arthur Mark, Chong Jenny P C, Lai Mitchell Kim Peng, Chen Christopher
From the Memory, Ageing and Cognition Centre (MACC), National University Health System, Singapore (SH, YLC, MKI, SE, XX, JYC, NV, MKPL, CC); Department of Pharmacology, National University of Singapore, Singapore (SH, YLC, XX, JYC, MKPL, CC); Singapore Eye Research Institute, Singapore National Eye Center, Singapore (MKI); Department of Ophthalmology, National University of Singapore, Singapore (MKI); St. Luke's Hospital, Singapore (TBY, NV); Neuroscience Clinic, Raffles Hospital, Singapore (NV); and Cardiovascular Research Institute, National University Heart Centre, Singapore (AMR, JPCC).
Medicine (Baltimore). 2015 Jan;94(1):e297. doi: 10.1097/MD.0000000000000297.
Markers of cardiac dysfunction such as amino terminal pro-brain natriuretic peptide (NTpro-BNP) and high sensitivity cardiac troponin T (hs-cTnT) may be associated with dementia. However, limited data exist on their association with either pre-dementia stages, that is, cognitive impairment no dementia (CIND), or the burden of cerebrovascular diseases (CeVD).We therefore, examined the association of these biomarkers of cardiac dysfunction with CeVD in both CIND and dementia.A case-control study, with cases recruited from memory clinics and controls from memory clinics and community. All subjects underwent collection of blood samples, neuropsychological assessment, and neuroimaging. Subjects were classified as CIND and dementia based on clinical criteria whilst significant CeVD was defined as the presence of cortical infarcts and/or more than 2 lacunes and/or confluent white matter lesions in two regions of brain on Age-Related White Matter Changes Scale.We included a total of 35 controls (mean age: 65.9 years), 78 CIND (mean age: 70.2 years) and 80 cases with dementia (mean age: 75.6 years). Plasma concentrations of hs-cTnT were associated significantly with CeVD in both CIND (odds ratios [OR]: 9.05; 95% confidence interval [CI]: 1.64-49.79) and dementia (OR: 16.89; 95%CI: 2.02-142.67). In addition, NTpro-BNP was associated with dementia with CeVD (OR: 7.74; 95%CI: 1.23-48.58). These associations were independent of other vascular risk factors.In this study, we showed that plasma NTproBNP and hs-cTnT are associated with dementia and CIND, only when accompanied by presence of CeVD.
心脏功能障碍标志物,如氨基末端脑钠肽前体(NTpro - BNP)和高敏心肌肌钙蛋白T(hs - cTnT),可能与痴呆症有关。然而,关于它们与痴呆前期阶段,即轻度认知障碍(CIND)或脑血管疾病(CeVD)负担之间关联的数据有限。因此,我们研究了这些心脏功能障碍生物标志物在CIND和痴呆症中与CeVD的关联。一项病例对照研究,病例从记忆诊所招募,对照从记忆诊所和社区招募。所有受试者均接受血样采集、神经心理学评估和神经影像学检查。根据临床标准将受试者分为CIND和痴呆症,而显著的CeVD定义为在年龄相关性白质改变量表上,大脑两个区域存在皮质梗死和/或超过2个腔隙和/或融合性白质病变。我们共纳入35名对照(平均年龄:65.9岁)、78名CIND患者(平均年龄:70.2岁)和80名痴呆症患者(平均年龄:75.6岁)。hs - cTnT的血浆浓度在CIND(比值比[OR]:9.05;95%置信区间[CI]:1.64 - 49.79)和痴呆症(OR:16.89;95%CI:2.02 - 142.67)中均与CeVD显著相关。此外,NTpro - BNP与伴有CeVD的痴呆症相关(OR:7.74;95%CI:1.23 - 48.58)。这些关联独立于其他血管危险因素。在本研究中,我们表明,血浆NTproBNP和hs - cTnT仅在伴有CeVD时才与痴呆症和CIND相关。