Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China.
Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.
J Alzheimers Dis. 2021;82(3):1357-1367. doi: 10.3233/JAD-210516.
Alterations in levels of peripheral insulin-like growth factor-1 (IGF-1) in Alzheimer's disease (AD) have been reported in several studies, and results are inconsistent.
We conducted a meta-analysis to investigate the relationship between peripheral and cerebrospinal fluid IGF-1 levels and AD or mild cognitive impairment (MCI).
A systematic search in PubMed, Medline, Web of Science, Embase, and Cochrane Library was conducted and 18 studies were included.
Results of random-effects meta-analysis showed that there was no significant difference between AD patients and healthy control (17 studies; standard mean difference [SMD], -0.01; 95%CI, -0.35 to 0.32) and between MCI patients and healthy control (6 studies; SMD, -0.20; 95%CI, -0.52 to 0.13) in peripheral IGF-1 levels. Meta-regression analyses identified age difference might explain the heterogeneity (p = 0.017). However, peripheral IGF-1 levels were significantly decreased in AD subjects (9 studies; SMD, -0.44; 95%CI, -0.81 to -0.07) and MCI subjects exhibited a decreasing trend (4 studies; SMD, -0.31; 95%CI, -0.72 to 0.11) in studies with sample size≥80. Cerebrospinal fluid IGF-1 levels also significantly decreased in AD subjects (3 studies; SMD, -2.40; 95%CI, -4.36 to -0.43).
These findings suggest that decreased peripheral and cerebrospinal fluid IGF-1 levels might be a potential marker for the cognitive decline and progression of AD.
几项研究报道了阿尔茨海默病(AD)患者外周血胰岛素样生长因子-1(IGF-1)水平的改变,但结果不一致。
我们进行了一项荟萃分析,以调查外周血和脑脊液 IGF-1 水平与 AD 或轻度认知障碍(MCI)之间的关系。
系统检索了 PubMed、Medline、Web of Science、Embase 和 Cochrane Library,并纳入了 18 项研究。
随机效应荟萃分析结果显示,AD 患者与健康对照组(17 项研究;标准均数差 [SMD],-0.01;95%CI,-0.35 至 0.32)和 MCI 患者与健康对照组(6 项研究;SMD,-0.20;95%CI,-0.52 至 0.13)的外周 IGF-1 水平无显著差异。Meta 回归分析发现年龄差异可能解释了异质性(p=0.017)。然而,在外周 IGF-1 水平低于 AD 患者(9 项研究;SMD,-0.44;95%CI,-0.81 至 -0.07)和 MCI 患者(4 项研究;SMD,-0.31;95%CI,-0.72 至 0.11)的样本量≥80 的研究中,IGF-1 水平呈显著下降趋势。AD 患者的脑脊液 IGF-1 水平也显著降低(3 项研究;SMD,-2.40;95%CI,-4.36 至 -0.43)。
这些发现表明,外周血和脑脊液 IGF-1 水平降低可能是 AD 认知下降和进展的潜在标志物。