阿尔茨海默病患者脂蛋白(a)水平与脑小血管病的关联
Associations of Lipoprotein(a) Level with Cerebral Small Vessel Disease in Patients with Alzheimer's Disease.
作者信息
Chen Nihong, Jiang Fuping, Chen Xiangliang, Zhu Lin, Qiao Na, Zhou Junshan, Zhang Yingdong
机构信息
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Department of Neurology, Nanjing Yuhua Hospital, Yuhua Branch of Nanjing First Hospital, Nanjing 210039, China.
出版信息
Brain Sci. 2023 Dec 29;14(1):34. doi: 10.3390/brainsci14010034.
BACKGROUND
This study aimed to examine the association of lipoprotein(a) [Lp(a)] level with the burden of cerebral small vessel disease (CSVD) in patients with Alzheimer's disease (AD).
METHODS
Data from 111 consecutive patients with AD admitted to Nanjing First Hospital from 2015 to 2022 were retrospectively analyzed in this study. Serum Lp(a) concentrations were grouped into tertiles (T1-T3). Brain magnetic resonance imaging (MRI) was rated for the presence of CSVD, including enlarged perivascular spaces (EPVS), lacunes, white-matter lesions, and cerebral microbleeds (CMBs). The CSVD burden was calculated by summing the scores of each MRI marker at baseline. A binary or ordinal logistic regression model was used to estimate the relationship of serum Lp(a) levels with CSVD burden and each MRI marker.
RESULTS
Patients with higher tertiles of Lp(a) levels were less likely to have any CSVD (T1, 94.6%; T2, 78.4%; T3, 66.2%; = 0.013). Multivariable analysis found that Lp(a) levels were inversely associated with the presence of CSVD (T2 vs. T1: adjusted odds ratio [aOR] 0.132, 95% confidence interval [CI] 0.018-0.946, = 0.044; T3 vs. T1: aOR 0.109, 95% CI 0.016-0.737, = 0.023) and CSVD burden (T3 vs. T1: aOR 0.576, 95% CI 0.362-0.915, = 0.019). The independent relationship between Lp(a) levels and individual CSVD features was significant for moderate-to-severe EPVS in the centrum semiovale (T2 vs. T1: aOR 0.059, 95% CI 0.006-0.542, = 0.012; T3 vs. T1: aOR 0.029, 95% CI 0.003-0.273, = 0.002) and CMBs (T3 vs. T1: aOR 0.144, 95% CI 0.029-0.716, = 0.018).
CONCLUSIONS
In this study, serum Lp(a) level was inversely associated with CSVD in AD patients.
背景
本研究旨在探讨脂蛋白(a)[Lp(a)]水平与阿尔茨海默病(AD)患者脑小血管病(CSVD)负担之间的关联。
方法
本研究回顾性分析了2015年至2022年在南京第一医院收治的111例连续性AD患者的数据。血清Lp(a)浓度分为三分位数(T1-T3)。对脑磁共振成像(MRI)进行CSVD评估，包括血管周围间隙扩大(EPVS)、腔隙、白质病变和脑微出血(CMB)。通过将每个MRI标记物在基线时的评分相加来计算CSVD负担。采用二元或有序逻辑回归模型估计血清Lp(a)水平与CSVD负担及每个MRI标记物之间的关系。
结果
Lp(a)水平较高三分位数的患者发生任何CSVD的可能性较小(T1，94.6%；T2，78.4%；T3，66.2%；P = 0.013)。多变量分析发现，Lp(a)水平与CSVD的存在呈负相关(T2与T1相比：调整优势比[aOR]0.132，95%置信区间[CI]0.018-0.946，P = 0.044；T3与T1相比：aOR 0.109，95%CI 0.016-0.737，P = 0.023)以及CSVD负担(T3与T1相比：aOR 0.576，95%CI 0.362-0.915，P = 0.019)。Lp(a)水平与个体CSVD特征之间的独立关系在半卵圆中心中度至重度EPVS方面具有显著性(T2与T1相比：aOR 0.059，95%CI 0.006-0.542，P = 0.012；T3与T1相比：aOR 0.029，95%CI 0.003-0.273，P = 0.002)以及CMB方面(T3与T1相比：aOR 0.144，95%CI 0.029-0.716，P = 0.018)。
结论
在本研究中，血清Lp(a)水平与AD患者的CSVD呈负相关。
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