Old Age Psychiatry, Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland.
Departement of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland.
Exp Gerontol. 2017 Dec 15;100:45-53. doi: 10.1016/j.exger.2017.10.013. Epub 2017 Oct 17.
Several studies have identified an association between body mass index (BMI) and the incidence and severity of Alzheimer's disease (AD) but this relationship is not fully understood.
The primary objective of this study was to assess the possible association between BMI and cerebrospinal fluid (CSF) biomarkers of AD pathology in subjects with normal cognition and cognitive impairment. The secondary objective was to test whether BMI may contribute to improve the accuracy of a clinical model to predict AD pathology in memory clinic patients with cognitive impairment.
One hundred and seven elderly subjects with cognitive impairment (91 memory clinic patients with mild cognitive impairment [MCI] and 16 with dementia of AD type) and 55 cognitively healthy volunteers were included in this study. All subjects received a comprehensive clinical and neuropsychological evaluation and a lumbar puncture for CSF biomarker analysis. Multiple linear regressions and receiver operating characteristic (ROC) analyses were carried out to assess the association between BMI and the CSF biomarkers of AD pathology.
BMI was positively correlated with the CSF levels of Aβ and negatively with tau and P-tau181 in participants with cognitive impairment. The associations were independent of age, sex, educational level, type and severity of cognitive impairment, cerebrovascular risk factors and the presence of the APOEε4 allele. Furthermore, BMI significantly improved the sensitivity and specificity of a multi-factorial model to predict the presence of an AD CSF biomarker profile.
Lower BMI is associated with cerebral AD pathology rather than with cognitive impairment in elderly subjects with MCI and mild dementia. Along with other clinical factors, decreasing BMI may help the clinician to identify patients with cognitive impairment due to AD.
多项研究已经发现体重指数（BMI）与阿尔茨海默病（AD）的发生和严重程度之间存在关联，但这种关系尚未完全阐明。
本研究的主要目的是评估BMI与认知正常和认知障碍患者的脑脊液（CSF）AD 病理生物标志物之间的可能关联。次要目的是检验 BMI 是否有助于提高临床模型预测认知障碍记忆门诊患者 AD 病理的准确性。
本研究纳入了 107 名认知障碍老年人（91 名轻度认知障碍[MCI]记忆门诊患者和 16 名 AD 型痴呆患者）和 55 名认知健康的志愿者。所有患者均接受了全面的临床和神经心理学评估以及腰椎穿刺以进行 CSF 生物标志物分析。采用多元线性回归和接收者操作特征（ROC）分析来评估 BMI 与 AD 病理 CSF 生物标志物之间的关联。
在认知障碍患者中，BMI 与 CSF 中 Aβ的水平呈正相关，与 tau 和 P-tau181 呈负相关。这些关联独立于年龄、性别、教育程度、认知障碍的类型和严重程度、脑血管危险因素和 APOEε4 等位基因。此外，BMI 显著提高了多因素模型预测 AD CSF 生物标志物谱存在的敏感性和特异性。
在 MCI 和轻度痴呆的老年患者中，较低的 BMI 与大脑 AD 病理有关，而与认知障碍无关。与其他临床因素一起，降低 BMI 可能有助于临床医生识别因 AD 导致认知障碍的患者。
