Zahr Natalie, Pfefferbaum Adolf
Res Sq. 2024 Jan 11:rs.3.rs-3822513. doi: 10.21203/rs.3.rs-3822513/v1.
Urine albumin, high in kidney disease, predicts cardiovascular incidents and CNS white matter hyperintensity (WMH) burdens. Serum albumin - a more general biomarker which can be low in several disorders - including kidney and liver disease, malnutrition, and inflammation - also predicts cardiovascular events and is associated with cognitive impairment in several clinical populations; relations between serum albumin and WMH prevalence, however, have rarely been evaluated. In a sample of 160 individuals with alcohol use disorder (AUD), 142 infected with HIV, and 102 healthy controls, the hypothesis was tested that lower serum albumin levels would predict larger WMH volumes and worse cognitive performance irrespective of diagnosis. After considering traditional cardiovascular risk factors (e.g., age, sex, body mass index (BMI), nicotine use, hypertension, diabetes) and study-relevant variables (i.e., primary diagnoses, race, socioeconomic status, hepatitis C virus status), serum albumin survived false discovery rate (FDR)-correction in contributing variance to larger periventricular but not deep WMH volumes. This relationship was salient in the AUD and HIV groups, but not the control group. In secondary analyses, serum albumin and periventricular WMH along with age, sex, diagnoses, BMI, and hypertension were considered for hierarchical contribution to variance in performance in 4 cognitive domains. Albumin survived FDR-correction for significantly contributing to visual and verbal learning and memory performance after accounting for diagnosis. Relations between albumin and markers of liver integrity [e.g., aspartate transaminase (AST)] and blood status (e.g., hemoglobin, red blood cell count, red cell distribution width) suggest that in this sample, albumin reflects both liver dysfunction and hematological abnormalities. The current results suggest that albumin, a simple serum biomarker available in most clinical settings, can predict variance in periventricular WMH volumes and performance in visual and verbal learning and memory cognitive domains. Whether serum albumin contributes mechanistically to periventricular WMH prevalence will require additional investigation.
尿白蛋白在肾脏疾病中含量较高，可预测心血管事件和中枢神经系统白质高信号（WMH）负担。血清白蛋白是一种更通用的生物标志物，在包括肾脏和肝脏疾病、营养不良及炎症在内的多种病症中可能偏低，它也能预测心血管事件，并且在多个临床群体中与认知障碍相关；然而，血清白蛋白与WMH患病率之间的关系鲜有评估。在一个包含160名酒精使用障碍（AUD）患者、142名感染HIV者及102名健康对照者的样本中，研究了这样一个假设：无论诊断结果如何，较低的血清白蛋白水平都将预示更大的WMH体积和更差的认知表现。在考虑了传统心血管危险因素（如年龄、性别、体重指数（BMI）、吸烟、高血压、糖尿病）以及与研究相关的变量（即主要诊断、种族、社会经济地位、丙型肝炎病毒感染状况）后，血清白蛋白在对更大的脑室周围而非深部WMH体积的方差贡献方面，通过了错误发现率（FDR）校正。这种关系在AUD组和HIV组中显著，但在对照组中不显著。在二次分析中，考虑了血清白蛋白和脑室周围WMH以及年龄、性别、诊断、BMI和高血压对4个认知领域表现方差的分层贡献。在考虑诊断因素后，白蛋白在对视觉和言语学习及记忆表现的方差贡献方面通过了FDR校正。白蛋白与肝脏完整性标志物[如天冬氨酸转氨酶（AST）]和血液状态（如血红蛋白、红细胞计数、红细胞分布宽度）之间的关系表明，在该样本中，白蛋白反映了肝功能障碍和血液学异常。当前结果表明，白蛋白作为一种在大多数临床环境中都可获取的简单血清生物标志物，能够预测脑室周围WMH体积的方差以及视觉和言语学习及记忆认知领域的表现。血清白蛋白是否在机制上导致脑室周围WMH患病率升高还需要进一步研究。
