Li Qin, Zhan Jiehong, Liao Zixuan, Li Jiayu, Li Xiaofeng
Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
Department of Neurology, The First People's Hospital of Yibin, Sichuan, 644000, China.
Heliyon. 2024 Sep 5;10(17):e37507. doi: 10.1016/j.heliyon.2024.e37507. eCollection 2024 Sep 15.
This study aimed to investigate the association of hemoglobin (Hb) with axonal injury marker plasma neurofilament light (PNFL) and brain structure measurements in the Alzheimer's disease (AD) continuum.
The data used in this study were collected from the Alzheimer's Disease Neuroimaging Initiative database. Participants with cognitively normal, mild cognitive impairment, and mild dementia were included in the data analyses. All participants had available data on blood tests, PNFL levels, neuropsychological assessments, brain structure measurements (including volumes of white matter hyperintensities [WMH], hippocampus, gray matter, and total brain), and Aβ positron emission tomography standardized uptake value ratio (SUVR) at baseline. Aβ-positive was defined as SUVR threshold value > 1.11. Linear regression, restricted cubic spline, and causal mediation analyses were conducted to investigate the association of Hb concentration with PNFL levels and brain structure measurements. Stratified analyses were also employed to evaluate the association between Hb concentration and PNFL levels across different APOE genotypes and sex.
In the Aβ-positive group, Hb concentration was associated with PNFL levels (β = -0.022, p = 0.002). Stratified analyses suggested an association between Hb concentration and PNFL in APOE ɛ4 carriers (β = -0.031, p < 0.001) and males (β = -0.030, p < 0.001) but not in non-carriers and females (p > 0.05). Hb concentration was also associated with WMH volume (β = -0.04, p = 0.028), especially in APOE ɛ4 carriers, with mediation analysis revealing that PNFL mediated the association between Hb concentration and WMH volume. The association of Hb concentration with other brain structure measurements was minimal.
In the AD continuum, Hb was associated with axonal injury marker PNFL and WMH volume, particularly in APOE ɛ4 carriers.
本研究旨在探讨血红蛋白（Hb）与阿尔茨海默病（AD）连续体中轴突损伤标志物血浆神经丝轻链（PNFL）及脑结构测量值之间的关联。
本研究使用的数据来自阿尔茨海默病神经影像学倡议数据库。认知正常、轻度认知障碍和轻度痴呆的参与者被纳入数据分析。所有参与者在基线时均有血液检测、PNFL水平、神经心理学评估、脑结构测量值（包括白质高信号[WMH]、海马体、灰质和全脑体积）以及淀粉样蛋白β（Aβ）正电子发射断层扫描标准化摄取值比率（SUVR）的可用数据。Aβ阳性定义为SUVR阈值>1.11。进行线性回归、受限立方样条分析和因果中介分析，以研究Hb浓度与PNFL水平及脑结构测量值之间的关联。还采用分层分析来评估不同载脂蛋白E（APOE）基因型和性别中Hb浓度与PNFL水平之间的关联。
在Aβ阳性组中，Hb浓度与PNFL水平相关（β=-0.022，p=0.002）。分层分析表明，APOEε4携带者（β=-0.031，p<0.001）和男性（β=-0.030，p<0.001）中Hb浓度与PNFL相关，而非携带者和女性中则无此关联（p>0.05）。Hb浓度还与WMH体积相关（β=-0.04，p=0.028），尤其是在APOEε4携带者中，中介分析显示PNFL介导了Hb浓度与WMH体积之间的关联。Hb浓度与其他脑结构测量值的关联极小。
在AD连续体中，Hb与轴突损伤标志物PNFL及WMH体积相关，尤其是在APOEε4携带者中。
