为期1年的营养混合补充剂对社区居住老年人血浆p-tau181和GFAP水平的影响：诺兰试验的二次分析
Effect of a 1-Year Nutritional Blend Supplementation on Plasma p-tau181 and GFAP Levels among Community-Dwelling Older Adults: A Secondary Analysis of the Nolan Trial.
作者信息
Giudici K V, de Souto Barreto P, Guyonnet S, Cantet C, Zetterberg H, Boschat C, Hudry J, Andrieu S, Schmitt J A J, Vellas B, Blennow K
机构信息
Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.
CERPOP UMR1295, University of Toulouse III, Inserm, UPS, Toulouse, France.
出版信息
JAR Life. 2023 Jun 12;12:25-34. doi: 10.14283/jarlife.2023.7. eCollection 2023.
BACKGROUND
Observational studies and some randomized controlled trials have suggested that nutritional supplementation could be a possible intervention pathway to prevent cognitive decline and Alzheimer's disease (AD). As measuring amyloid-β and tau pathophysiology by positron emission tomography (PET) or cerebrospinal fluid (CSF) analyses may be perceived as complex, plasma versions of such biomarkers have emerged as more accessible alternatives with comparable capacity of predicting cognitive impairment.
OBJECTIVES
This study aimed to evaluate the effect of a 1-year intervention with a nutritional blend on plasma p-tau181 and glial fibrillary acidic protein (GFAP) levels in community-dwelling older adults. Effects were further assessed in exploratory analyses within sub-cohorts stratified according to p-tau status (with the third tertile considered as high: ≥15.1 pg/ mL) and to apolipoprotein E (APOE) ε4 allele status.
METHODS
A total of 289 participants ≥70 years (56.4% female, mean age 78.1 years, SD=4.7) of the randomized, double-blind, multicenter, placebo-controlled Nolan trial had their plasma p-tau181 assessed, and daily took either a nutritional blend (composed of thiamin, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, folic acid, cobalamin, vitamin E, vitamin C, vitamin D, choline, selenium, citrulline, eicosapentaenoic acid - EPA, and docosahexaenoic acid - DHA) or placebo for 1 year.
RESULTS
After 1-year, both groups presented a significant increase in plasma p-tau181 and GFAP values, with no effect of the intervention (p-tau181 between-group difference: 0.27pg/mL, 95%CI: -0.95, 1.48; p=0.665; GFAP between-group difference: -3.28 pg/mL, 95%CI: -17.25, 10.69; p=0.644). P-tau-and APOE ε4-stratified analyses provided similar findings.
CONCLUSIONS
In community-dwelling older adults, we observed an increase in plasma p-tau181 and GFAP levels that was not different between the supplementation groups after one year.
背景
观察性研究和一些随机对照试验表明，营养补充可能是预防认知衰退和阿尔茨海默病（AD）的一种可能的干预途径。由于通过正电子发射断层扫描（PET）或脑脊液（CSF）分析来测量淀粉样蛋白-β和tau病理生理学可能被认为很复杂，此类生物标志物的血浆版本已成为更易于获取的替代方法，且具有预测认知障碍的相当能力。
目的
本研究旨在评估为期1年的营养混合物干预对社区居住的老年人血浆p-tau181和胶质纤维酸性蛋白（GFAP）水平的影响。在根据p-tau状态（将第三个三分位数视为高：≥15.1 pg/mL）和载脂蛋白E（APOE）ε4等位基因状态分层的亚组中进行探索性分析，进一步评估其效果。
方法
随机、双盲、多中心、安慰剂对照的诺兰试验共有289名年龄≥70岁的参与者（56.4%为女性，平均年龄78.1岁，标准差=4.7），对其血浆p-tau181进行评估，并每天服用营养混合物（由硫胺素、核黄素、烟酸、泛酸、吡哆醇、生物素、叶酸、钴胺素、维生素E、维生素C、维生素D、胆碱、硒、瓜氨酸、二十碳五烯酸 - EPA和二十二碳六烯酸 - DHA组成）或安慰剂，持续1年。
结果
1年后，两组的血浆p-tau181和GFAP值均显著升高，干预无效果（组间p-tau181差异：0.27 pg/mL，95%置信区间：-0.95，1.48；p = 0.665；组间GFAP差异：-3.28 pg/mL，95%置信区间：-17.25，10.69；p = 0.644）。p-tau和APOE ε4分层分析得出了类似的结果。
结论
在社区居住的老年人中，我们观察到血浆p-tau181和GFAP水平升高，1年后补充组之间无差异。
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