Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Social Health Medicine, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
J Alzheimers Dis. 2022;88(2):731-741. doi: 10.3233/JAD-220195.
Mid-regional pro-adrenomedullin (MR-proADM) is a novel biomarker for cognitive decline based on its association with cerebral small vessel disease (SVD). Cerebral microbleeds (MBs) are characteristic of SVD; however, a direct association between MR-proADM and MBs has not been explored.
We aimed to examine whether circulating levels of MR-proADM are associated with the identification of MBs by brain magnetic resonance imaging (MRI) and whether this association could be linked with cognitive impairment.
In total, 214 participants (mean age: 75.9 years) without history of cerebral infarction or dementia were prospectively enrolled. All participants underwent brain MRI, higher cognitive function testing, blood biochemistry evaluation, lifestyle examination, and blood MR-proADM measurement using a time-resolved amplified cryptate emission technology assay. For between-group comparisons, the participants were divided into two groups according to whether their levels of MR-proADM were normal (< 0.65 nmol/L) or high (≥0.65 nmol/L).
The mean MR-proADM level was 0.515±0.127 nmol/L. There were significant between-group differences in age, hypertension, and HbA1c levels (p < 0.05). In the high MR-proADM group, the MR-proADM level was associated with the identification of MBs on brain MR images and indications of mild cognitive impairment (MCI). In participants with ≥3 MBs and MCI, high MR-proADM levels remained a risk factor after multivariate adjustment (OR: 2.94; p < 0.05).
High levels of MR-proADM may be a surrogate marker for the early detection of cognitive decline associated with the formation of cerebral MBs. This marker would be valuable during routine clinical examinations of geriatric patients.
中肽素（MR-proADM）是一种新型生物标志物，可用于预测认知能力下降，其与脑小血管疾病（SVD）有关。脑微出血（MBs）是 SVD 的特征之一；然而，MR-proADM 与 MBs 之间的直接关联尚未得到探索。
我们旨在研究循环中 MR-proADM 水平是否与脑 MRI 识别 MBs 相关，以及这种关联是否与认知障碍有关。
共纳入 214 名无脑梗死或痴呆病史的参与者（平均年龄：75.9 岁）。所有参与者均接受脑 MRI、高级认知功能测试、血液生化评估、生活方式检查和采用时间分辨增强荧光技术测定血液中 MR-proADM 水平。为了进行组间比较，根据 MR-proADM 水平是否正常（<0.65 nmol/L）或升高（≥0.65 nmol/L），将参与者分为两组。
MR-proADM 的平均水平为 0.515±0.127 nmol/L。两组间在年龄、高血压和 HbA1c 水平方面存在显著差异（p<0.05）。在高 MR-proADM 组中，MR-proADM 水平与脑 MRI 图像上 MBs 的检出和轻度认知障碍（MCI）相关。在有≥3 个 MBs 和 MCI 的参与者中，即使经过多变量调整，高 MR-proADM 水平仍为认知能力下降的危险因素（OR：2.94；p<0.05）。
高 MR-proADM 水平可能是一种预测与脑 MBs 形成相关的认知能力下降的早期标志物。在老年患者的常规临床检查中，该标志物可能具有重要价值。
