Xing Yi, Tang Yi, Zhao Lina, Wang Qi, Qin Wei, Zhang Jin-Lan, Jia Jianping
Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
J Alzheimers Dis. 2016 Apr 12;52(3):1029-35. doi: 10.3233/JAD-151158.
Various evidence demonstrates the influences of ceramides on Alzheimer's disease (AD) pathogenesis. Furthermore, increased ceramides were also suggested to be related to cognitive decline. However, the association between ceramides and neuropsychiatric symptoms of AD remains unclear.
This study sought to investigate the association between plasma ceramide levels and multiple neuropsychiatric symptoms in AD.
A total of 98 patients and 92 cognitively normal controls participated in this study, including 56 with mild AD and 42 with moderate to severe AD. The Neuropsychiatric Inventory (NPI) was used to assess neuropsychiatric symptoms. Considering the influences of dementia severity on ceramide levels and neuropsychiatric symptoms, a subgroup analysis was conducted by dementia severity.
Except for C24 : 0, all ceramide species were significantly higher in AD patients than in controls. After controlling for confounding factors, the C16 : 0 and C20 : 0 levels were positively associated with delusions, and the quartiles of C22 : 0 and C24 : 0 were positively associated with depression. In the subgroup analysis, association between ceramide species and delusions were only observed in mild AD, and the association between ceramides and depression were prominent in moderate to severe AD. In mild AD, after controlling for age, gender, anti-dementia medications, diabetes status, and ApoE ɛ4 status, the C16 : 0, C20 : 0, and quartiles of C24 : 1 were associated with delusions. In moderate to severe AD, depression was associated with C22 : 0 and C24 : 0.
There were stage-specific associations between ceramides and neuropsychiatric symptoms of AD. The potential mechanisms deserve further investigation.
各种证据表明神经酰胺对阿尔茨海默病（AD）发病机制有影响。此外，神经酰胺增加也被认为与认知功能下降有关。然而，神经酰胺与AD神经精神症状之间的关联仍不清楚。
本研究旨在探讨血浆神经酰胺水平与AD患者多种神经精神症状之间的关联。
共有98例患者和92例认知正常对照者参与本研究，其中轻度AD患者56例，中度至重度AD患者42例。采用神经精神科问卷（NPI）评估神经精神症状。考虑到痴呆严重程度对神经酰胺水平和神经精神症状的影响，按痴呆严重程度进行亚组分析。
除C24 : 0外，AD患者所有神经酰胺种类均显著高于对照组。在控制混杂因素后，C16 : 0和C20 : 0水平与妄想呈正相关，C22 : 0和C24 : 0四分位数与抑郁呈正相关。在亚组分析中，仅在轻度AD中观察到神经酰胺种类与妄想之间的关联，而在中度至重度AD中神经酰胺与抑郁之间的关联较为突出。在轻度AD中，控制年龄、性别、抗痴呆药物、糖尿病状态和ApoE ɛ4状态后，C16 : 0、C20 : 0和C24 : 1四分位数与妄想有关。在中度至重度AD中，抑郁与C22 : 0和C24 : 0有关。
神经酰胺与AD神经精神症状之间存在阶段特异性关联。其潜在机制值得进一步研究。
