Andreev Alexander, Erdinc Burak, Shivaraj Kiran, Schmutz Julia, Levochkina Olga, Bhowmik Dhrity, Farag Fady, Money Kelli M, Primavera Louis H, Gotlieb Vladimir, Sahni Sonu
Brookdale University Hospital Medical Center, Department of Internal Medicine, Brooklyn, NY, USA.
Beth Israel Deaconess Medical Center, Department of Neurology, Boston, MA, USA.
J Alzheimers Dis Rep. 2020 Sep 18;4(1):379-391. doi: 10.3233/ADR-200178.
Dementia is a spectrum of neurological diseases characterized by memory impairment and cognitive decline with the pathogenesis and effective management remaining elusive. Several studies have identified a correlation between anemia and Alzheimer's disease and related dementias (ADRD); however, anemia subtypes and association with ADRD have yet to be studied conclusively.
To study an association between ADRD and anemia of chronic inflammation.
We conducted a retrospective case-control study of the patients, diagnosed with ADRD at Brookdale Hospital. Pair-wise comparisons between means of controls and cases in terms of iron studies and laboratory results were performed using a Mann-Whitney U test. Pair-wise comparisons between anemia subgroups (moderate and severe) were performed using a Two Sample proportion Z-Test, where for each couple of normally distributed population.
There was a total of 4,517 (1,274 ADRD group; 3,243 Control group) patients. There was significant difference in hemoglobin 10.15 versus 11.04 [-value <0.001]. Iron studies showed a significant difference in ferritin 395±488.18 versus 263±1023.4 [ < 0.001], total iron binding capacity 225±84.08 versus 266±82.30 [ < 0.001] and serum iron level 64±39.34 versus 53±41.83 [ < 0.001]. Folic acid and vitamin B12 levels were normal in both groups. Severe and moderate anemia in the ADRD group were respectively 6.2% [95% CI: 4.2-8.4] and 13% [95% CI: 9.8-16.2] higher. Overall, incidence of moderate-to-severe anemia was found to be 19% higher in ADRD group [95% CI: 15.8-22.1].
We demonstrated an association between ADRD and anemia of chronic inflammation independent of age, renal function, and HgbA1C levels.
痴呆是一系列神经疾病，其特征为记忆障碍和认知衰退，发病机制及有效治疗方法仍不明确。多项研究已确定贫血与阿尔茨海默病及相关痴呆症（ADRD）之间存在关联；然而，贫血亚型及其与ADRD的关联尚未得到最终研究。
研究ADRD与慢性炎症性贫血之间的关联。
我们对在布鲁克代尔医院被诊断为ADRD的患者进行了一项回顾性病例对照研究。使用曼-惠特尼U检验对对照组和病例组在铁代谢研究及实验室检查结果方面的均值进行成对比较。对贫血亚组（中度和重度）进行成对比较时使用双样本比例Z检验，适用于每对正态分布总体。
共有4517名患者（1274名ADRD组；3243名对照组）。血红蛋白存在显著差异，分别为10.15和vs 11.04 [-值<0.001]。铁代谢研究显示，铁蛋白分别为395±488.18和vs 263±1023.4 [<0.001]、总铁结合力分别为225±84.08和vs 266±82.30 [<0.001]以及血清铁水平分别为64±39.34和vs 53±41.83 [<0.001]存在显著差异。两组的叶酸和维生素B12水平均正常。ADRD组的重度和中度贫血分别高出6.2% [95%置信区间：4.2 - 8.4]和13% [95%置信区间：9.8 - 16.2]。总体而言，发现ADRD组中重度至中度贫血的发生率高出19% [95%置信区间：15.8 - 22.1]。
我们证明了ADRD与慢性炎症性贫血之间存在关联，且不受年龄、肾功能和糖化血红蛋白水平的影响。
