Park Sun Ah, Chae Won Seok, Kim Hyeong Jun, Shin Ho Sik, Kim Saeromi, Im Ji Young, Ahn Sang Il, Min Kyoung Dae, Yim Soo Jae, Ye Byoung Seok, Seo Sang Won, Jeong Jee Hyang, Park Kyung Won, Choi Seong Hye, Na Duk L
Departments of *Neurology †Anesthesiology and Pain Medicine ‡Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon §Department of Neurology, Yonsei University College of Medicine ∥Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine ¶Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul #Department of Neurology, College of Medicine, Institute of Convergence Bio-Health, Dong-A University, Busan **Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea.
Alzheimer Dis Assoc Disord. 2017 Jan-Mar;31(1):13-18. doi: 10.1097/WAD.0000000000000184.
Laboratory-specific reference values for cerebrospinal fluid (CSF) Alzheimer disease (AD) biomarkers are necessary. Our objective was to apply well-known CSF biomarkers and redetermine their diagnostic cutoff values for AD in South Korea. CSF samples from matched control subjects (n=71), patients with AD dementia (ADD, n=76), and other neurological disorders with cognitive decline (OND, n=47) were obtained from 6 Korean dementia clinics according to a standardized protocol. CSF biomarker concentrations were measured using enzyme-linked immunosorbent assay. CSF biomarkers differed significantly between the ADD and control groups (P<0.001 for all), and between the ADD and OND groups (P<0.001 for all). The areas under the curve in differentiation of ADD from control subjects were 0.97 for Aβ42, 0.93 for total tau (tTau), 0.86 for pTau, and 0.99 for both tTau/Aβ42 and pTau/Aβ42 ratios. Our revised cutoff value for Aβ42 was higher than our previous one, whereas the values for the Tau proteins were similar. The tTau/Aβ42 ratio had the highest accuracy, 97%. Our findings highlight the usefulness of CSF AD biomarkers in South Korea, and the necessity of continually testing the reliability of cutoff values.
脑脊液（CSF）阿尔茨海默病（AD）生物标志物的实验室特定参考值是必要的。我们的目标是应用知名的脑脊液生物标志物，并重新确定其在韩国用于AD诊断的临界值。根据标准化方案，从6家韩国痴呆症诊所获取了匹配的对照受试者（n = 71）、AD痴呆患者（ADD，n = 76）以及其他伴有认知衰退的神经系统疾病患者（OND，n = 47）的脑脊液样本。使用酶联免疫吸附测定法测量脑脊液生物标志物浓度。ADD组与对照组之间的脑脊液生物标志物存在显著差异（所有P < 0.001），ADD组与OND组之间也存在显著差异（所有P < 0.001）。在区分ADD与对照受试者时，Aβ42的曲线下面积为0.97，总tau（tTau）为0.93，磷酸化tau（pTau）为0.86，tTau/Aβ42和pTau/Aβ42比值均为0.99。我们修订后的Aβ42临界值高于之前的，而Tau蛋白的临界值相似。tTau/Aβ42比值的准确性最高，为97%。我们的研究结果凸显了脑脊液AD生物标志物在韩国的有用性，以及持续检测临界值可靠性的必要性。
