Ferré-González Laura, Peña-Bautista Carmen, Álvarez-Sánchez Lourdes, Ferrer-Cairols Inés, Baquero Miguel, Cháfer-Pericás Consuelo
Alzheimer's Disease Research Group, Health Research Institute La Fe, 46026 Valencia, Spain.
Division of Neurology, University and Polytechnic Hospital La Fe, 46026 Valencia, Spain.
Antioxidants (Basel). 2021 Oct 22;10(11):1662. doi: 10.3390/antiox10111662.
Alzheimer's disease (AD) is the leading cause of dementia in the elderly population. Currently, diagnosis is based on invasive and expensive techniques, so there is a growing need to look for other possible tests, as well as carry out clinical validation. Studies from the literature showed potential diagnosis models, including some AD risk factors (age, gender, ApoE-ε4 genotype) and other variables (biomarkers levels, neuroimaging). Specifically, a recent model was performed from lipid peroxidation compounds in plasma samples to identify patients with early AD. However, there is a lack of studies about clinical validation of these preliminary diagnosis models.
Plasma samples from participants classified into AD ( = 61), non-AD ( = 17), and healthy ( = 44) were analyzed. In fact, lipid peroxidation compounds were determined by liquid chromatography and mass spectrometry. Then, a previously developed diagnosis model was clinically validated, evaluating some diagnosis indexes.
The validation of the preliminary diagnosis model showed satisfactory diagnosis indexes (accuracy 77%, sensitivity 89%, specificity 61%, diagnostic odds ratio 12.5, positive predictive value 76%). Next, a useful screening tool, including the ApoE genotype, was developed, identifying patients with a higher risk of developing AD and improving the corresponding diagnosis indexes (accuracy 82%, sensitivity 81%, specificity 85%, diagnostic odds ratio 23.2, positive predictive value 90.5%).
A new screening approach could improve the early, minimally invasive, and differential AD diagnosis in the general population.
阿尔茨海默病（AD）是老年人群痴呆的主要病因。目前，诊断基于侵入性且昂贵的技术，因此越来越需要寻找其他可能的检测方法，并进行临床验证。文献研究显示了潜在的诊断模型，包括一些AD风险因素（年龄、性别、载脂蛋白E-ε4基因型）和其他变量（生物标志物水平、神经影像学）。具体而言，最近有一个基于血浆样本中脂质过氧化化合物的模型用于识别早期AD患者。然而，缺乏关于这些初步诊断模型临床验证的研究。
对分为AD组（n = 61）、非AD组（n = 17）和健康组（n = 44）的参与者的血浆样本进行分析。实际上，通过液相色谱和质谱法测定脂质过氧化化合物。然后，对先前开发的诊断模型进行临床验证，评估一些诊断指标。
初步诊断模型的验证显示出令人满意的诊断指标（准确率77%，灵敏度89%，特异性61%，诊断比值比12.5，阳性预测值76%）。接下来，开发了一种有用的筛查工具，包括载脂蛋白E基因型，可识别患AD风险较高的患者并改善相应的诊断指标（准确率82%，灵敏度81%，特异性85%，诊断比值比23.2，阳性预测值90.5%）。
一种新的筛查方法可改善普通人群中AD的早期、微创和鉴别诊断。
