Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden.
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, SE-431 80 Mölndal, Sweden.
Psychoneuroendocrinology. 2017 Dec;86:169-175. doi: 10.1016/j.psyneuen.2017.09.018. Epub 2017 Sep 21.
Insulin-like growth factor-I (IGF-I) is important for the adult brain, but little is known of the role of IGF-I in Alzheimeŕs disease (AD) or vascular dementia (VaD).
A prospective study of 342 patients with subjective or objective mild cognitive impairment recruited at a single memory clinic. We determined whether serum IGF-I concentrations at baseline were associated with the risk of all-cause dementia, AD, or VaD. Patients developing mixed forms of AD and VaD were defined as suffering from VaD. The statistical analyses included Cox proportional hazards regression analysis.
During the follow-up (mean 3.6 years), 95 (28%) of the patients developed all-cause dementia [AD, n=37 (11%) and VaD, n=42 (12%)]. Low as well as high serum IGF-I (quartile 1 or 4 vs. quartiles 2-3) did not associate with all-cause dementia [crude hazard ratio (HR) 1.30, 95% confidence interval (CI): 0.81-2.08 and crude HR 1.05, 95% CI: 0.63-1.75, respectively] or AD (crude HR 0.79, 95% CI: 0.35-1.79 and crude HR 0.94, 95% CI: 0.43-2.06, respectively]. In contrast, low serum IGF-I concentrations were associated with increased risk of VaD (quartile 1 vs. quartiles 2-3, crude HR 2.22, 95% CI: 1.13-4.36). The latter association remained significant also after adjustment for multiple covariates.
In a memory clinic population, low serum IGF-I was a risk marker for subsequent VaD whereas low IGF-I did not associate with the risk of AD. High serum IGF-I was not related to the risk of conversion to dementia.
胰岛素样生长因子-I（IGF-I）对成人大脑很重要，但对于 IGF-I 在阿尔茨海默病（AD）或血管性痴呆（VaD）中的作用知之甚少。
这是一项在单个记忆诊所招募的 342 名主观或客观轻度认知障碍患者的前瞻性研究。我们确定基线时血清 IGF-I 浓度是否与全因痴呆、AD 或 VaD 的风险相关。发展为 AD 和 VaD 混合形式的患者被定义为患有 VaD。统计分析包括 Cox 比例风险回归分析。
在随访期间（平均 3.6 年），95 名（28%）患者发生全因痴呆[AD，n=37（11%）和 VaD，n=42（12%）]。低浓度和高浓度的血清 IGF-I（第 1 或 4 四分位数与第 2-3 四分位数相比）与全因痴呆[粗危险比（HR）1.30，95%置信区间（CI）：0.81-2.08 和粗 HR 1.05，95% CI：0.63-1.75]或 AD（粗 HR 0.79，95% CI：0.35-1.79 和粗 HR 0.94，95% CI：0.43-2.06）无关。相反，低浓度的血清 IGF-I 与 VaD 的风险增加相关（第 1 四分位数与第 2-3 四分位数相比，粗 HR 2.22，95% CI：1.13-4.36）。在调整了多个协变量后，这种关联仍然具有统计学意义。
在记忆诊所人群中，低浓度的血清 IGF-I 是 VaD 发生的风险标志物，而低 IGF-I 与 AD 的风险无关。高浓度的血清 IGF-I 与痴呆转化的风险无关。
