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老年人阿尔茨海默病伴或不伴抑郁患者的 C 反应蛋白升高:来自健康与退休研究的结果。

Elevated C-Reactive Protein in Alzheimer's Disease Without Depression in Older Adults: Findings From the Health and Retirement Study.

机构信息

Program in Public Health and Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA.

出版信息

J Gerontol A Biol Sci Med Sci. 2022 Apr 1;77(4):673-682. doi: 10.1093/gerona/glab282.

Abstract

We examined the association between differential diagnoses of major stroke and probable Alzheimer's disease (AD) and mixed AD on C-reactive protein (CRP) in older adults with and without depression. Secondary data analyses examined associations between blood-based measures of probable peripheral inflammation using CRP collected from dried blood spots in the Health and Retirement Study, a nationally representative sample of individuals aged 50 and older. A validated pattern-recognition algorithm was utilized to identify cognitive decline indicative of probable AD, mixed AD, and major stroke. Negative binomial regressions were utilized to model concentrations of serologic CRP. On average, participants (N = 4 601) were 70 years old, female, and non-Hispanic White. Mixed AD participants had a 0.26 mg/dL increase in CRP compared to unimpaired participants, controlling for demographics, health behaviors, and comorbidities. Those with mixed AD had 2.14 times increased odds of having high CRP (odds ratio = 2.14 [1.19-3.85]). In analyses stratified by depression, adults with mixed AD and without depression had an additional 0.37 mg/dL increase in CRP (SE = 0.06; p < .001) compared to unimpaired adults. Those with AD without depression had a 0.20 mg/dL increase in CRP (SE = 0.07; p < .01). Age was not associated with increased CRP in nondepressed older adults. Depressed adults with major stroke had a -0.26 mg/dL decrease in CRP (SE = 0.11; p = .02), controlling for hypertension, alcoholic drinks/beverages per week, and smoking status. Concentration modeling revealed that participants with major stroke, probable AD, and probable mixed AD without depression had significantly higher CRP concentrations when compared to unimpaired older adults.

摘要

我们研究了在有或没有抑郁的老年患者中,主要中风和可能的阿尔茨海默病(AD)以及混合 AD 的不同诊断与 C 反应蛋白(CRP)之间的关系。二次数据分析检查了来自健康与退休研究中老年人干血斑的 CRP 等血液中潜在外周炎症的指标与认知能力下降的关联,健康与退休研究是一个具有代表性的 50 岁及以上人群样本。采用一种经过验证的模式识别算法来识别可能的 AD、混合 AD 和主要中风的认知能力下降模式。采用负二项回归模型来对 CRP 的血清浓度进行建模。平均而言,参与者(N=4601)的年龄为 70 岁,女性,且为非西班牙裔白人。与未受损的参与者相比,混合 AD 患者的 CRP 增加了 0.26mg/dL,控制了人口统计学、健康行为和合并症等因素。与混合 AD 相关的人 CRP 水平升高的几率增加了 2.14 倍(比值比=2.14[1.19-3.85])。在按抑郁状况分层的分析中,患有混合 AD 且无抑郁的成年人的 CRP 比未受损的成年人增加了 0.37mg/dL(SE=0.06;p<.001)。无抑郁的 AD 患者 CRP 增加了 0.20mg/dL(SE=0.07;p<.01)。在无抑郁的老年人群中,年龄与 CRP 升高无关。患有主要中风且抑郁的成年人的 CRP 降低了 0.26mg/dL(SE=0.11;p=0.02),控制了高血压、每周饮酒/饮料量和吸烟状况。浓度建模显示,与未受损的老年人相比,患有主要中风、可能的 AD 和无抑郁的可能混合 AD 的参与者的 CRP 浓度显著更高。

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