美国印第安人阿尔茨海默病及相关痴呆症的血浆生物标志物：“强壮心脏研究”。
Plasma biomarkers of Alzheimer's disease and related dementias in American Indians: The Strong Heart Study.
机构信息
Washington State University Elson S Floyd College of Medicine, Spokane, Washington, USA.
Huntington Medical Research Institutes, Pasadena, California, USA.
出版信息
Alzheimers Dement. 2024 Mar;20(3):2072-2079. doi: 10.1002/alz.13664. Epub 2024 Jan 12.
INTRODUCTION
Identification of Alzheimer's disease (AD) needs inexpensive, noninvasive biomarkers, with validation in all populations.
METHODS
We collected plasma markers in older American Indian individuals: phosphorylated-tau181 (pTau181); amyloid-beta (Aβ) 40,42; glial fibrillary acidic protein (GFAP); and neurofilament light chain (NfL). Plasma markers were analyzed for discriminant properties with cognitive status and etiology using receiver operating characteristic (ROC) analysis.
RESULTS
PTau181, GFAP, NfL plasma values were significantly associated with cognition, but Aβ were not. Discriminant performance was moderate for individual markers, with pTau181, GFAP, NfL performing best, but an empirically selected panel of markers (age, sex, education, pTau181, GFAP, NfL, Aβ4240 ratio) had excellent discriminant performance (AUC > 0.8).
DISCUSSION
In American Indian individuals, pTau181 and Aβ values suggested more common pathology than in majority populations. Aβ was less informative than in other populations; however, all four markers were needed for a best-performing dementia diagnostic model. These data validate utility of AD plasma markers, while suggesting population-specific diagnostic characteristics.
简介
需要找到价格低廉、非侵入性的生物标志物来识别阿尔茨海默病（AD），且该标志物应在所有人群中得到验证。
方法
我们收集了美国印第安老年人的血浆标志物：磷酸化tau181（pTau181）、β淀粉样蛋白（Aβ）40、42、胶质纤维酸性蛋白（GFAP）和神经丝轻链（NfL）。使用接收者操作特征（ROC）分析，根据认知状态和病因学对血浆标志物的判别特性进行了分析。
结果
pTau181、GFAP、NfL 血浆值与认知功能显著相关，但 Aβ 则不然。单独标志物的判别性能为中等，pTau181、GFAP、NfL 的性能最好，但经验选择的标志物组合（年龄、性别、教育、pTau181、GFAP、NfL、Aβ4240 比值）具有出色的判别性能（AUC>0.8）。
讨论
在美洲印第安人个体中，pTau181 和 Aβ 值提示了比大多数人群更常见的病理变化。Aβ 不如其他人群中的信息丰富；然而，为了实现最佳的痴呆症诊断模型，需要所有四种标志物。这些数据验证了 AD 血浆标志物的实用性，同时提示了人群特异性的诊断特征。
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