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代谢综合征与衰老大脑中的淀粉样蛋白沉积

Metabolic Syndrome and Amyloid Accumulation in the Aging Brain.

机构信息

Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, USA.

Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.

出版信息

J Alzheimers Dis. 2018;65(2):629-639. doi: 10.3233/JAD-180297.

Abstract

BACKGROUND

Recent studies show links between metabolic syndrome and Alzheimer's disease (AD) neuropathology. Understanding the link between vascular-related health conditions and dementia will help target at risk populations and inform clinical strategies for early detection and prevention of AD.

OBJECTIVE

To determine whether metabolic syndrome is associated with global cerebral amyloid-β (Aβ) positivity and longitudinal Aβ accumulation.

METHODS

Prospective study of 165 participants who underwent (11)C-Pittsburgh compound B (PiB) PET neuroimaging to measure Aβ, from June 2005 to May 2016. Metabolic syndrome was defined using the revised Third Adults Treatment Panel of the National Cholesterol Education Program criteria. Participants were classified as PiB+/-. Linear mixed effects models assessed the relationships between baseline metabolic syndrome and PiB status and regional Aβ change over time.

RESULTS

A total of 165 cognitively normal participants of the Baltimore Longitudinal Study of Aging (BLSA) Neuroimaging substudy, aged 55-92 years (mean baseline age = 76.4 years, 85 participants were male), received an average of 2.5 PET-PiB scans over an average interval of 2.6 (3.08 SD) years between first and last visits. Metabolic syndrome was not associated with baseline PiB positivity or concurrent regional Aβ. Metabolic syndrome was associated with increased rates of Aβ accumulation in superior parietal and precuneus regions over time in the PiB+ group. Elevated fasting glucose and blood pressure showed individual associations with accelerated Aβ accumulation.

CONCLUSION

Metabolic syndrome was associated with accelerated Aβ accumulation in PiB+ individuals and may be an important factor in the progression of AD pathology.

摘要

背景

最近的研究表明代谢综合征与阿尔茨海默病(AD)的神经病理学之间存在联系。了解与血管相关的健康状况与痴呆之间的联系将有助于确定高危人群,并为 AD 的早期检测和预防提供临床策略。

目的

确定代谢综合征是否与全脑淀粉样蛋白-β(Aβ)阳性和纵向 Aβ积累有关。

方法

对 165 名参与者进行了前瞻性研究,这些参与者在 2005 年 6 月至 2016 年 5 月期间接受了(11)C-匹兹堡化合物 B(PiB)正电子发射断层扫描(PET)神经成像,以测量 Aβ。代谢综合征使用修订后的国家胆固醇教育计划成人治疗专家组第三版标准定义。根据 PiB+/-将参与者分类。线性混合效应模型评估了基线代谢综合征与 PiB 状态以及随时间变化的区域 Aβ变化之间的关系。

结果

巴尔的摩纵向研究老龄化(BLSA)神经影像学子研究的 165 名认知正常参与者,年龄在 55-92 岁之间(平均基线年龄为 76.4 岁,85 名参与者为男性),在第一次和最后一次就诊之间的平均间隔 2.6(3.08 SD)年内接受了平均 2.5 次 PET-PiB 扫描。代谢综合征与基线 PiB 阳性或同期区域 Aβ无关。代谢综合征与 PiB+组中随时间推移顶叶和楔前叶区域 Aβ积累率的增加有关。空腹血糖和血压升高与 Aβ积累的加速有关。

结论

代谢综合征与 PiB+个体中 Aβ积累的加速有关,可能是 AD 病理进展的重要因素。

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