Peters Kirsten E, Davis Wendy A, Taddei Kevin, Martins Ralph N, Masters Colin L, Davis Timothy M E, Bruce David G
School of Medicine and Pharmacology, University of Western Australia, Fremantle, WA, Australia.
School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia.
J Alzheimers Dis. 2017;56(3):1127-1133. doi: 10.3233/JAD-161050.
Plasma amyloid-β (Aβ) levels have rarely been investigated in type 2 diabetes despite its known associations with Alzheimer's disease.
To compare blood plasma Aβ concentrations (Aβ40 and Aβ42) in cognitively normal individuals with and without type 2 diabetes.
Plasma Aβ40 and Aβ42 were measured in 194 participants with diabetes recruited from the community-based Fremantle Diabetes Study Phase II cohort (mean age 71 years, 59% males) and 194 age-, sex-, and APOEɛ4 allele-matched, control subjects without diabetes from the Australian Imaging, Biomarkers and Lifestyle Study using a multiplex microsphere-based immunoassay.
Plasma Aβ40 and Aβ42 were normally distributed in the controls but were bimodal in the participants with diabetes. Median Aβ40 and Aβ42 concentrations were significantly lower in those with type 2 diabetes (Aβ40 median [inter-quartile range]: 125.0 [52.6-148.3] versus 149.3 [134.0-165.6] pg/mL; Aβ42: 26.9 [14.5-38.3] versus 33.6 [28.0-38.9] pg/mL, both p < 0.001) while the ratio Aβ42:Aβ40 was significantly higher (0.26 [0.23-0.32] versus 0.22 [0.19-0.25], p < 0.001). After adjustment, participants with diabetes and plasma Aβ40 levels in the low peak of the bimodal distribution were significantly more likely to have normal to high estimated glomerular filtration rates (odds ratio (95% CI): 2.40 (1.20-4.80), p = 0.013) although the group with diabetes had lower renal function overall.
Type 2 diabetes is associated with altered plasma concentrations of Aβ peptides and is an important source of variation that needs to be taken into account when considering plasma Aβ peptides as biomarkers for Alzheimer's disease.
尽管已知血浆淀粉样蛋白-β(Aβ)水平与阿尔茨海默病有关,但在2型糖尿病患者中对此的研究却很少。
比较认知功能正常的2型糖尿病患者与非2型糖尿病患者的血浆Aβ浓度(Aβ40和Aβ42)。
采用基于微球的多重免疫分析法,对从社区招募的194名弗里曼特尔糖尿病研究二期队列中的糖尿病患者(平均年龄71岁,男性占59%)和194名年龄、性别及APOEɛ4等位基因匹配的非糖尿病对照者(来自澳大利亚影像、生物标志物和生活方式研究)的血浆Aβ40和Aβ42进行检测。
血浆Aβ40和Aβ42在对照组中呈正态分布,而在糖尿病患者中呈双峰分布。2型糖尿病患者的Aβ40和Aβ42中位数浓度显著较低(Aβ40中位数[四分位间距]:125.0[52.6 - 148.3]对149.3[134.0 - 165.6] pg/mL;Aβ42:26.9[14.5 - 38.3]对33.6[28.0 - 38.9] pg/mL,p均<0.001),而Aβ42:Aβ40比值显著更高(0.26[0.23 - 0.32]对0.22[0.19 - 0.25],p<0.001)。调整后,糖尿病患者且血浆Aβ40水平处于双峰分布低峰的患者,其估计肾小球滤过率正常至高的可能性显著更高(优势比(95%可信区间):2.40(1.20 - 4.80),p = 0.013),尽管糖尿病组总体肾功能较低。
2型糖尿病与血浆Aβ肽浓度改变有关,并且在将血浆Aβ肽作为阿尔茨海默病生物标志物进行考量时,是一个需要考虑的重要变异来源。