一项系统评价和荟萃分析评估了伴有或不伴有阻塞性睡眠呼吸暂停的成年人的阿尔茨海默病生物标志物。

A systematic review with meta-analysis to assess Alzheimer's disease biomarkers in adults with or without obstructive sleep apnoea.

机构信息

Oral and Maxillofacial Surgery Department, School of Dentistry, Isfahan University of Medical Sciences, 81746-73461 Isfahan, Iran.

Department of Plastic Surgery, School of Medicine, Isfahan University of Medical Sciences, 81746-73461 Isfahan, Iran.

出版信息

Int Orthod. 2023 Dec;21(4):100814. doi: 10.1016/j.ortho.2023.100814. Epub 2023 Sep 28.

DOI:10.1016/j.ortho.2023.100814

PMID:37776696

Abstract

INTRODUCTION

The aim was to design a meta-analysis evaluating the positron emission tomography (PET) uptake and cerebrospinal fluid (CSF), circulating levels of amyloid-β (Aβ), and tau proteins OSA group versus control group, as well as the association of these biomarkers with the severity of OSA.

MATERIAL AND METHODS

Four databases were searched until April 17, 2023, without any restrictions. The effect sizes were the standardized mean difference (SMD) along with a 95% confidence interval (CI).

RESULTS

A total of 21 articles were entered into the meta-analysis. The pooled SMDs of the CSF levels in OSA adults compared to controls were: -0.82 (P=0.004) for Aβ42, -1.13 (P<0.001) for Aβ40, 0.17 (P=0.23) for p-tau, 0.04 (P=0.65) for t-tau, 0.08 (P=0.89) for Aβ42/Aβ40 ratio, and 0.81 (P=0.001) for t-tau/Aβ42 ratio. The pooled SMD for the PET uptake of Aβ burden in OSA adults compared to controls was 0.30 (P=0.03). The pooled SMDs of the circulating levels in OSA adults compared to controls were: 0.67 (P=0.002) for Aβ42, 0.11 (P=0.82) for Aβ40, 0.35 (P=0.06) for p-tau, and 1.41(P=0.005) for t-tau. The pooled SMDs for levels of Aβ42, Aβ40, total Aβ, p-tau, t-tau, and Aβ42/Aβ40 ratio in severe OSA adults compared to mild/moderate OSA adults were -0.15 (P=0.33), 0.25 (P=35), 0.04 (P=87), -2.53 (P=0.24), -0.24 (P=0.52), and -0.28 (P=0.30), respectively.

CONCLUSIONS

The results indicated that CSF levels of Aβ42 and Aβ40 in OSA adults were significantly lower, but the CSF level of t-tau/Aβ42 ratio and PET Aβ burden uptake in OSA adults significantly were higher than in controls.

摘要

简介

目的是设计一项荟萃分析，评估正电子发射断层扫描（PET）摄取以及脑脊液（CSF）、循环中的淀粉样蛋白-β（Aβ）和 tau 蛋白在阻塞性睡眠呼吸暂停（OSA）组与对照组中的水平，并评估这些生物标志物与 OSA 严重程度的相关性。

材料和方法

检索了四个数据库，截至 2023 年 4 月 17 日，没有任何限制。效应大小为标准化均数差（SMD）及其 95%置信区间（CI）。

结果

共有 21 篇文章纳入荟萃分析。与对照组相比，OSA 成人的 CSF 水平的合并 SMD 为：Aβ42 为-0.82（P=0.004），Aβ40 为-1.13（P<0.001），p-tau 为 0.17（P=0.23），t-tau 为 0.04（P=0.65），Aβ42/Aβ40 比值为 0.08（P=0.89），t-tau/Aβ42 比值为 0.81（P=0.001）。与对照组相比，OSA 成人的 PET 摄取 Aβ负荷的合并 SMD 为 0.30（P=0.03）。与对照组相比，OSA 成人的循环水平的合并 SMD 为：Aβ42 为 0.67（P=0.002），Aβ40 为 0.11（P=0.82），p-tau 为 0.35（P=0.06），t-tau 为 1.41（P=0.005）。与轻度/中度 OSA 成人相比，严重 OSA 成人的 CSF 中 Aβ42、Aβ40、总 Aβ、p-tau、t-tau 和 Aβ42/Aβ40 比值的合并 SMD 分别为-0.15（P=0.33）、0.25（P=35）、0.04（P=87）、-2.53（P=0.24）、-0.24（P=0.52）和-0.28（P=0.30）。