Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
Department of Geriatric Medicine, the Affiliated Hospital of Qingdao University, Qingdao, China.
Neurotox Res. 2021 Jun;39(3):609-617. doi: 10.1007/s12640-020-00312-y. Epub 2020 Nov 20.
Relationship between serum calcium and Alzheimer's disease (AD) remains unclear. The aim of this study is to test whether serum calcium is associated with other AD-associated biomarkers and could predict clinical progression in nondemented elders. This was a longitudinal population-based study. The sample was derived from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort, which included 1224 nondemented elders: 413 cognitively normal (CN) and 811 mild cognition impairment (MCI). Associations were investigated between serum calcium and longitudinal changes in Aβ/tau pathologic features, brain structure, cognitive function, and disease progression. Serum calcium concentrations increased with disease severity. Serum calcium predicted longitudinal cognitive decline and conversion from nondemented status to AD dementia (adjusted HR = 1.41, 95% CI 1.13-1.76). Furthermore, serum calcium levels were negatively correlated with CSF-Aβ (β = - 0.558, P = 0.008), FDG-PET (β = - 0.292, P < 0.001), whole brain volume (β = - 0.148, P = 0.001), and middle temporal volume (β = - 0.216, P = 0.042). Similar results were obtained in CN and MCI groups. Higher serum calcium status (even if not hypercalcemia) may increase the risk of AD in elders. Serum calcium is a useful biomarker in predicting clinical progression in nondemented elders. More researches are needed in the future to explore the underlying mechanism.
血清钙与阿尔茨海默病（AD）之间的关系尚不清楚。本研究旨在检验血清钙是否与其他 AD 相关生物标志物相关，以及是否可以预测无痴呆老年人的临床进展。这是一项纵向的基于人群的研究。样本来自阿尔茨海默病神经影像学倡议（ADNI）队列，其中包括 1224 名无痴呆老年人：413 名认知正常（CN）和 811 名轻度认知障碍（MCI）。研究了血清钙与 Aβ/tau 病理特征、脑结构、认知功能和疾病进展的纵向变化之间的关系。血清钙浓度随疾病严重程度而增加。血清钙预测纵向认知下降和从不痴呆状态向 AD 痴呆的转化（调整后的 HR=1.41，95%CI 1.13-1.76）。此外，血清钙水平与 CSF-Aβ（β=-0.558，P=0.008）、FDG-PET（β=-0.292，P<0.001）、全脑体积（β=-0.148，P=0.001）和颞中回体积（β=-0.216，P=0.042）呈负相关。在 CN 和 MCI 组中也得到了类似的结果。较高的血清钙状态（即使没有高钙血症）可能会增加老年人患 AD 的风险。血清钙是预测无痴呆老年人临床进展的有用生物标志物。未来需要进行更多的研究来探索其潜在机制。
