Nilsson Erik D, Melander Olle, Elmståhl Sölve, Lethagen Eva, Minthon Lennart, Pihlsgård Mats, Nägga Katarina
Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Sweden.
Department of Clinical Sciences, Lund University, Sweden.
J Alzheimers Dis. 2016 Apr 12;52(3):1047-53. doi: 10.3233/JAD-151118.
Copeptin is a reliable surrogate marker for the neurohypophyseal hormone vasopressin. Elevated plasma level of copeptin has been associated with cardiovascular and metabolic disease risk.
To investigate the association between copeptin and risk of dementia.
In all, 18,240 individuals from Malmö, Sweden, were examined between 2002 and 2006 (mean age 69.3 years, 69.8% men). Incident cases of dementia until 31 December 2009 were identified by linkage with the Swedish National Patient Register. To validate the dementia diagnoses, medical records as well as laboratory and neuroimaging data were carefully reviewed. Baseline level of copeptin was measured in frozen plasma in: (1) all participants who were diagnosed with dementia during follow-up, (2) a random sample of 5100 individuals of the cohort.
During a median follow-up of 4.2 years, there were 374 incident dementia cases (age range 60-83 years at baseline): 120 were classified as Alzheimer's disease (AD), 84 as vascular dementia (VaD), and 102 as mixed dementia. In logistic regressions adjusted for cardiovascular risk factors, baseline level of copeptin predicted incident VaD (Odds ratio (OR) 1.30 per 1 SD increase in log copeptin, 95% CI 1.03-1.64). Copeptin did not predict incidence of all-cause dementia (OR 1.05, 95% CI 0.94-1.18), AD (OR 0.97, 95% CI 0.79-1.18), or mixed dementia (OR 0.85, 95% CI 0.68-1.05).
Elevated plasma level of copeptin is a risk marker for incident VaD, but not for incident AD. This suggests that the vasopressin hormonal system might be involved in the development of VaD.
copeptin是神经垂体激素血管加压素的可靠替代标志物。血浆copeptin水平升高与心血管和代谢疾病风险相关。
研究copeptin与痴呆风险之间的关联。
2002年至2006年间，对来自瑞典马尔默的18240名个体进行了检查（平均年龄69.3岁，男性占69.8%）。通过与瑞典国家患者登记处的关联，确定了截至2009年12月31日的痴呆症发病病例。为了验证痴呆症诊断，仔细审查了病历以及实验室和神经影像数据。在以下人群的冷冻血浆中测量了copeptin的基线水平：（1）随访期间被诊断患有痴呆症的所有参与者，（2）该队列中随机抽取的5100名个体。
在中位随访4.2年期间，有374例痴呆症发病病例（基线年龄范围为60 - 83岁）：120例被分类为阿尔茨海默病（AD），84例为血管性痴呆（VaD），102例为混合性痴呆。在针对心血管危险因素进行调整的逻辑回归中，copeptin的基线水平可预测VaD的发病（copeptin对数每增加1个标准差，优势比（OR）为1.30，95%置信区间为1.03 - 1.64）。Copeptin不能预测全因痴呆症的发病率（OR为1.05，95%置信区间为0.94 - 1.18）、AD（OR为0.97，95%置信区间为0.79 - 1.18）或混合性痴呆（OR为0.85，95%置信区间为0.68 - 1.05）。
血浆copeptin水平升高是VaD发病的风险标志物，但不是AD发病的风险标志物。这表明血管加压素激素系统可能参与了VaD的发生发展。
