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60岁及以上患者中高敏C反应蛋白与阿尔茨海默病发病的关联:挪威HUNT研究

The association of high sensitivity C-reactive protein and incident Alzheimer disease in patients 60 years and older: The HUNT study, Norway.

作者信息

Gabin Jessica Mira, Saltvedt Ingvild, Tambs Kristian, Holmen Jostein

机构信息

1HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Forskningsveien 2, 7600 Levanger, Norway.

2Department of Neuromedicine and Movement science, NTNU, the Faculty of Medicine and Health, Post Office Box 8905, 7491 Trondheim, Norway.

出版信息

Immun Ageing. 2018 Jan 22;15:4. doi: 10.1186/s12979-017-0106-3. eCollection 2018.

Abstract

BACKGROUND

With ageing, long-standing inflammation can be destructive, contributing to development of several disorders, among these Alzheimer's disease (AD). C-reactive protein (CRP) is a relatively stable peripheral inflammatory marker, but in previous studies the association between highly sensitive CRP (hsCRP) and AD have shown inconsistent results. This study examines the association between AD and hsCRP in blood samples taken up to 15 years prior to the diagnoses of 52 persons with AD amongst a total of 2150 persons ≥60 years of age.

RESULTS

Data from Norway's Nord-Trøndelag Health Study (HUNT 2) and the Health and Memory Study (HMS) were linked. The participants had an average age of 73 years, and diagnosed with AD up to 15 years [mean 8.0 (±3.9)] following hsCRP measurement. Logistic regression models showed an adverse association between hsCRP and AD in participants aged 60-70.5 (odds ratio: 2.37, 95% CI: 1.01-5.58). Conversely, in participants aged 70.6-94, there was an inverse association between hsCRP and AD (odds ratio: 0.39, 95% CI: 0.19-0.84). When applying multivariate models the findings were significant in individuals diagnosed 0.4-7 years after the hsCRP was measured; and attenuated when AD was diagnosed more than seven years following hsCRP measurement.

CONCLUSIONS

Our study is in line with previous studies indicating a shift in the association between hsCRP and AD by age: in adults (60-70.5 years) there is an adverse association, while in seniors (>70.6 years) there is an inverse association. If our findings can be replicated, a focus on why a more active peripheral immune response may have a protective role in individuals ≥70 years should be further examined.

摘要

背景

随着年龄增长,长期炎症可能具有破坏性,会促使多种疾病的发生,其中包括阿尔茨海默病(AD)。C反应蛋白(CRP)是一种相对稳定的外周炎症标志物,但在以往研究中,高敏CRP(hsCRP)与AD之间的关联结果并不一致。本研究在2150名60岁及以上人群中,对52例AD患者诊断前长达15年采集的血样进行检测,以研究AD与hsCRP之间的关联。

结果

挪威北特伦德拉格健康研究(HUNT 2)和健康与记忆研究(HMS)的数据进行了关联。参与者的平均年龄为73岁,在测量hsCRP后长达15年[平均8.0(±3.9)]被诊断为AD。逻辑回归模型显示,在60 - 70.5岁的参与者中,hsCRP与AD之间存在负相关(比值比:2.37,95%置信区间:1.01 - 5.58)。相反,在70.6 - 94岁的参与者中,hsCRP与AD之间存在正相关(比值比:0.39,95%置信区间:0.19 - 0.84)。应用多变量模型时,在hsCRP测量后0.4 - 7年被诊断的个体中,研究结果具有显著性;而在hsCRP测量7年以上被诊断为AD时,结果减弱。

结论

我们的研究与之前的研究一致,表明hsCRP与AD之间的关联随年龄变化:在成年人(60 - 70.5岁)中存在负相关,而在老年人(>70.6岁)中存在正相关。如果我们的研究结果能够得到重复验证,那么应该进一步研究为何更活跃的外周免疫反应可能对70岁及以上个体具有保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f9/5776764/7a9eb1c845f6/12979_2017_106_Fig1_HTML.jpg

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