Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Via Pace 9, 20122 Milan, Italy.
Nutrients. 2022 Nov 23;14(23):4973. doi: 10.3390/nu14234973.
Dysfunctions in liver metabolic activities may increase the risk of cognitive impairment and dementia. In a cohort of community-dwelling older persons investigated for a suspected cognitive decline, we studied the association between liver status and dementia, considering sex and frailty contribution. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations, and the AST/ALT ratio were used to assess liver function in 419 older adults (248 persons with dementia and 171 age- and sex-matched subjects without cognitive decline). Although the serum concentrations of the liver enzymes were in the physiologic range, patients with dementia showed lower ALT concentrations ( = 0.005) and higher AST/ALT ratios ( = 0.003) compared to controls. The same differences were found when comparing men with and without dementia (ALT, = 0.009; AST/ALT ratio, = 0.003) but disappeared in women. Curiously, comparing women and men with the same diagnosis, the ALT concentrations were lower ( = 0.008), and the AST/ALT ratio was higher ( = 0.001) in control women than men, whereas no significant difference was found between persons with dementia. In conclusion, in our cohort of older people living in the community, the association between serum aminotransferases and dementia was remarked. Moreover, our results support attention to sex difference in liver function, suggesting a role in the pathogenesis of dementia.
肝脏代谢功能障碍可能会增加认知障碍和痴呆的风险。在一项针对疑似认知能力下降的社区居住老年人进行的队列研究中，我们研究了肝脏状况与痴呆之间的关系，同时考虑了性别和虚弱的影响。我们使用血清丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）浓度以及 AST/ALT 比值来评估 419 名老年人（248 名痴呆患者和 171 名年龄和性别匹配的无认知能力下降的受试者）的肝功能。尽管血清酶浓度处于生理范围内，但与对照组相比，痴呆患者的 ALT 浓度较低（=0.005），AST/ALT 比值较高（=0.003）。在比较有和无痴呆的男性时也发现了相同的差异（ALT，=0.009；AST/ALT 比值，=0.003），但在女性中则没有。奇怪的是，在比较具有相同诊断的女性和男性时，与男性相比，女性的 ALT 浓度较低（=0.008），AST/ALT 比值较高（=0.001），而痴呆患者之间则没有显著差异。总之，在我们的社区老年人队列中，发现血清转氨酶与痴呆之间存在关联。此外，我们的结果支持关注肝功能的性别差异，表明其在痴呆发病机制中发挥作用。
