Polymeris Alexandros A, Helfenstein Fabrice, Benkert Pascal, Aeschbacher Stefanie, Leppert David, Coslovsky Michael, Willemse Eline, Schaedelin Sabine, Blum Manuel R, Rodondi Nicolas, Reichlin Tobias, Moschovitis Giorgio, Wuerfel Jens, De Marchis Gian Marco, Engelter Stefan T, Lyrer Philippe A, Conen David, Kühne Michael, Osswald Stefan, Bonati Leo H, Kuhle Jens
Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
Front Neurosci. 2022 Apr 14;16:819010. doi: 10.3389/fnins.2022.819010. eCollection 2022.
Serum neurofilament light chain (sNfL) is increasingly used as a neuroaxonal injury biomarker in the elderly. Besides age, little is known about how other physiological factors like renal function and body mass index (BMI) alter its levels. Here, we investigated the association of estimated glomerular filtration rate (eGFR) and BMI with sNfL in a large sample of elderly patients with atrial fibrillation (AF).
This is a cross-sectional analysis from the Swiss-AF Cohort (NCT02105844). We measured sNfL using an ultrasensitive single-molecule array assay. We calculated eGFR using the chronic kidney disease epidemiology collaboration (CKD-EPI) creatinine (eGFR) and creatinine-cystatin C (eGFR) formulas, and BMI from weight and height measurements. We evaluated the role of eGFR and BMI as determinants of sNfL levels using multivariable linear regression and the adjusted R (R).
Among 2,277 Swiss-AF participants (mean age 73.3 years), eGFR showed an inverse curvilinear association with sNfL after adjustment for age and cardiovascular comorbidities. BMI also showed an independent, inverse linear association with sNfL. The R of models with age, eGFR, and BMI alone was 0.26, 0.35, and 0.02, respectively. A model with age and eGFR combined explained 45% of the sNfL variance. Sensitivity analyses (i) further adjusting for vascular brain lesions ( = 1,402 participants with MRI) and (ii) using eGFR yielded consistent results.
In an elderly AF cohort, both renal function and BMI were associated with sNfL, but only renal function explained a substantial proportion of the sNfL variance. This should be taken into account when using sNfL in elderly patients or patients with cardiovascular disease.
血清神经丝轻链（sNfL）越来越多地被用作老年人神经轴突损伤的生物标志物。除年龄外，对于肾功能和体重指数（BMI）等其他生理因素如何改变其水平知之甚少。在此，我们在大量老年房颤（AF）患者样本中研究了估计肾小球滤过率（eGFR）和BMI与sNfL的关联。
这是一项来自瑞士房颤队列（NCT02105844）的横断面分析。我们使用超灵敏单分子阵列分析测定sNfL。我们使用慢性肾脏病流行病学协作组（CKD-EPI）的肌酐（eGFR）公式和肌酐-胱抑素C（eGFR）公式计算eGFR，并根据体重和身高测量值计算BMI。我们使用多变量线性回归和调整后的R²（R²）评估eGFR和BMI作为sNfL水平决定因素的作用。
在2277名瑞士房颤参与者（平均年龄73.3岁）中，在调整年龄和心血管合并症后，eGFR与sNfL呈反向曲线关联。BMI也与sNfL呈独立的反向线性关联。仅包含年龄、eGFR和BMI的模型的R²分别为0.26、0.35和0.02。一个包含年龄和eGFR的组合模型解释了sNfL方差的45%。敏感性分析（i）进一步调整血管性脑损伤（1402名有MRI检查的参与者）和（ii）使用eGFR得出了一致的结果。
在老年房颤队列中，肾功能和BMI均与sNfL相关，但只有肾功能解释了sNfL方差的很大一部分。在老年患者或心血管疾病患者中使用sNfL时应考虑到这一点。
