From the Department of Neuropsychiatry (J.W.K.), Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do; Department of Psychiatry (J.W.K.), Hallym University College of Medicine, Chuncheon, Gangwan-do; Institute of Human Behavioral Medicine (M.S.B., D.Y., D.Y.L.), Medical Research Center Seoul National University; Departments of Neuropsychiatry (J.H.L., D.Y.L.) and Radiology (K.M.K., C.-H.S.), Seoul National University Hospital; Department of Psychiatry (S.Y.J.), Chungnam National University Hospital, Daejeon; Sanggye Paik Hospital (B.K.S.), Department of Psychiatry, Inje University College of Medicine; Departments of Neuropsychiatry (J.-Y.L.) and Nuclear Medicine (S.A.S., Y.K.K.), SMG-SNU Boramae Medical Center; and Department of Psychiatry (J.-Y.L., D.Y.L.), Seoul National University College of Medicine, Republic of Korea.
Neurology. 2020 Aug 18;95(7):e815-e826. doi: 10.1212/WNL.0000000000010005. Epub 2020 Jul 20.
To investigate the relationships of serum albumin with in vivo Alzheimer disease (AD) pathologies, including cerebral β-amyloid (Aβ) protein deposition, neurodegeneration of AD-signature regions, and cerebral white matter hyperintensities (WMH), in the human brain.
A total of 396 older adults without dementia underwent comprehensive clinical assessments, measurement of serum albumin level, and multimodal brain imaging, including [C] Pittsburgh compound B-PET, F-fluorodeoxyglucose-PET, and MRI. Serum albumin was categorized as follows: <4.4 g/dL (low albumin), 4.4 to 4.5 g/dL (middle albumin), and >4.5 g/dL (high albumin; used as a reference category). Aβ positivity, AD-signature region cerebral glucose metabolism (AD-CM), AD-signature region cortical thickness (AD-CT), and WMH volume were used as outcome measures.
Serum albumin level (as a continuous variable) was inversely associated with Aβ deposition and Aβ positivity. The low albumin group showed a significantly higher Aβ positivity rate compared to the high albumin group (odds ratio 3.40, 95% confidence interval 1.67-6.92, = 0.001), while the middle albumin group showed no difference (odds ratio 1.74, 95% confidence interval 0.80-3.77, = 0.162). Neither serum albumin level (as a continuous variable) nor albumin categories were related to AD-CM, AD-CT, or WMH volume.
Low serum albumin may increase the risk of AD dementia by elevating amyloid accumulation. In terms of AD prevention, more attention needs to be paid to avoid a low serum albumin level, even within the clinical normal range, by clinicians.
研究血清白蛋白与体内阿尔茨海默病（AD）病理学之间的关系，包括脑内β-淀粉样蛋白（Aβ）蛋白沉积、AD 特征区域的神经退行性变以及脑白质高信号（WMH）。
共有 396 名无痴呆的老年人接受了全面的临床评估、血清白蛋白水平测量以及多模态脑成像，包括[C]匹兹堡化合物 B-PET、F-氟脱氧葡萄糖-PET 和 MRI。血清白蛋白分为以下几类：<4.4 g/dL（低白蛋白）、4.4 至 4.5 g/dL（中白蛋白）和>4.5 g/dL（高白蛋白；作为参考类别）。Aβ阳性、AD 特征区域脑葡萄糖代谢（AD-CM）、AD 特征区域皮质厚度（AD-CT）和 WMH 体积作为结果指标。
血清白蛋白水平（作为连续变量）与 Aβ沉积和 Aβ阳性呈负相关。低白蛋白组的 Aβ阳性率明显高于高白蛋白组（优势比 3.40，95%置信区间 1.67-6.92， = 0.001），而中白蛋白组则无差异（优势比 1.74，95%置信区间 0.80-3.77， = 0.162）。血清白蛋白水平（作为连续变量）或白蛋白类别均与 AD-CM、AD-CT 或 WMH 体积无关。
低血清白蛋白可能通过增加淀粉样蛋白积累而增加 AD 痴呆的风险。在 AD 预防方面，临床医生需要更加关注避免低血清白蛋白水平，即使在临床正常范围内。
