Institute of Physiology and Coimbra Institute for Clinical and Biomedical Researh (iCBR), Faculty of Medicine, University of Coimbra, Portugal.
Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Portugal.
J Alzheimers Dis. 2019;67(2):725-735. doi: 10.3233/JAD-180669.
Adipose tissue dysfunction has been implicated in the pathophysiology of Alzheimer's disease. However, the involvement of adipokines, particularly adiponectin, remains unclear.
To compare serum and cerebrospinal fluid (CSF) levels of adiponectin, leptin and leptin-to-adiponectin ratio in patients within the spectrum of Alzheimer's disease and evaluate their relationship with classical biomarkers and their value as markers of progression.
Amnestic mild cognitive impairment (MCI, n = 71) and Alzheimer's dementia (AD, n = 53) subjects were consecutively recruited for serum and CSF adiponectin and leptin determination using an analytically validated commercial enzyme-linked immunosorbent assay (ELISA). Correlations were explored using adjusted Spearman's correlation coefficients. A logistic regression model and ROC analysis were performed to evaluate the staging predictive value of adipokines.
Serum adiponectin was 33% higher in AD when compared to MCI patients. Adiponectin CSF levels, similar in both groups, were positively correlated with Aβ42 and cognitive function, though only in women. The area under the ROC curve was 0.673 (95% CI:0.57-0.78) for serum adiponectin as predictor of dementia stage and the cut-off 10.85μg/ml maximized the sum of specificity (87%) and sensitivity (44%).
Although longitudinal studies are required, we hypothesize that higher serum adiponectin in AD patients constitutes a strategy to compensate possible central signaling defects. In addition, adiponectin might be specifically assigned to neuroprotective functions in women and eventually involved in the female-biased incidence of Alzheimer's disease.
脂肪组织功能障碍与阿尔茨海默病的病理生理学有关。然而，脂肪因子（尤其是脂联素）的参与仍不清楚。
比较阿尔茨海默病谱中患者的血清和脑脊液（CSF）脂联素、瘦素和瘦素与脂联素比值，并评估其与经典生物标志物的关系及其作为进展标志物的价值。
连续招募遗忘型轻度认知障碍（MCI，n = 71）和阿尔茨海默病痴呆（AD，n = 53）患者，使用经过分析验证的商业酶联免疫吸附测定（ELISA）法测定血清和 CSF 脂联素和瘦素。使用调整后的斯皮尔曼相关系数探讨相关性。使用逻辑回归模型和 ROC 分析评估了脂联素的分期预测价值。
与 MCI 患者相比，AD 患者的血清脂联素高 33%。两组的 CSF 脂联素水平相似，但与 Aβ42 和认知功能呈正相关，不过仅在女性中如此。血清脂联素作为痴呆阶段预测因子的 ROC 曲线下面积为 0.673（95%CI：0.57-0.78），截距 10.85μg/ml 最大程度地提高了特异性（87%）和敏感性（44%）的总和。
虽然需要进行纵向研究，但我们假设 AD 患者血清中较高的脂联素构成了补偿可能的中枢信号缺陷的策略。此外，脂联素可能专门分配给女性的神经保护功能，并且最终可能与阿尔茨海默病的女性偏倚发生率有关。
