阿尔茨海默病在阻塞性睡眠呼吸暂停综合征中的发病风险：淀粉样蛋白-β和tau 成像。

Risk of Alzheimer's Disease in Obstructive Sleep Apnea Syndrome: Amyloid-β and Tau Imaging.

机构信息

Department of Molecular Imaging and Therapy, Austin Health, The University of Melbourne, Victoria, Australia.

Department of Psychiatry, The University of Melbourne, Victoria, Australia.

出版信息

J Alzheimers Dis. 2018;66(2):733-741. doi: 10.3233/JAD-180640.

DOI:10.3233/JAD-180640

PMID:30320587

Abstract

BACKGROUND

An association between obstructive sleep apnea (OSA) and Alzheimer's disease has been suggested but little is known about amyloid-β and tau deposition in this syndrome.

OBJECTIVE

To determine amyloid and tau burden and cognitive function in OSA in comparison with those without a diagnosis of OSA.

METHODS

The status of OSA was determined by asking participants about history of polysomnographic diagnosis of OSA and the use of Continuous Positive Airway Pressure (CPAP). A comprehensive neuropsychological battery measured cognitive function. Positron emission tomography (PET) was used to measure standardized uptake value ratio (SUVR) of 18F-florbetaben and 18F-AV1451, to quantify amyloid and tau burden.

RESULTS

119 male Vietnam veterans completed assessment. Impairment in visual attention and processing speed and increased body mass index (BMI) were seen in subjects with OSA compared with those without a diagnosis OSA. The cortical uptake of 18F-florbetaben was higher in the OSA group than in the control group (SUVR: 1.35±0.21 versus 1.27±0.16, p = 0.04). There were more apolipoprotein E ɛ4 allele (APOE ɛ4) carriers in the OSA group than in the control group. In multilinear regression analysis, the significance of OSA in predicting 18F-florbetaben uptake remained independent of age and vascular risk factors but not when BMI or APOE ɛ4 was adjusted. The reported use of CPAP (n = 14) had no effect on cognitive or amyloid PET findings. There was no significant difference in 18F-AV1451 uptake between the two groups.

CONCLUSIONS

Obstructive sleep apnea is associated with Alzheimer's disease pathology, but this relationship is moderated by APOE ɛ4 and BMI.

摘要

背景

阻塞性睡眠呼吸暂停（OSA）与阿尔茨海默病之间存在关联，但对于该综合征中的淀粉样蛋白-β和 tau 沉积知之甚少。

目的

与没有 OSA 诊断的人相比，确定 OSA 患者的淀粉样蛋白和 tau 负担以及认知功能。

方法

通过询问参与者是否有 OSA 的多导睡眠图诊断史和是否使用持续气道正压通气（CPAP）来确定 OSA 的状态。使用综合神经心理学测试来测量认知功能。使用正电子发射断层扫描（PET）测量 18F-氟比他滨和 18F-AV1451 的标准化摄取值比（SUVR），以量化淀粉样蛋白和 tau 负担。

结果

119 名越南男性退伍军人完成了评估。与没有 OSA 诊断的人相比，OSA 患者的视觉注意力和处理速度受损，体重指数（BMI）增加。与对照组相比，OSA 组的 18F-氟比他滨皮质摄取更高（SUVR：1.35±0.21 与 1.27±0.16，p=0.04）。OSA 组的载脂蛋白 E ɛ4 等位基因（APOE ɛ4）携带者多于对照组。多元线性回归分析表明，OSA 对 18F-氟比他滨摄取的预测意义独立于年龄和血管危险因素，但与 BMI 或 APOE ɛ4 调整无关。报告使用 CPAP（n=14）对认知或淀粉样蛋白 PET 结果没有影响。两组之间 18F-AV1451 的摄取无显着差异。