Liang Chunhua, Yan Xueqin, Tian Jing, Yang Yunzhu, Xiao Xiaohua, Huang Yaohui, Wang Tianfu
Department of Geriatrics, Shenzhen Second People's Hospital, Shenzhen, China.
Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, China.
Aging Clin Exp Res. 2025 Mar 26;37(1):105. doi: 10.1007/s40520-025-03001-y.
Although blood-based biomarkers can be used to detect early Alzheimer's disease (AD), population differences affect their clinical value in early diagnosis of the disease spectrum.
To examine the potential of plasma biomarkers to detect different stages along the AD continuum in a Chinese population.
We enrolled 113 adults from the Shenzhen community (53 cognitively unimpaired [CU], 45 with mild cognitive impairment [MCI], and 15 with AD). We used the single-molecule array technique to detect the levels of glial fibrillary acidic protein (GFAP), neurofilament light (NfL), and phosphorylated-tau181 (p-tau181), and performed APOE genotyping. We assessed the association between plasma biomarkers and cognitive scores, and used receiver operating characteristic curves to measure performance for early AD diagnosis.
The plasma GFAP, NfL, and p-tau181 levels increased significantly in AD and were slightly higher in MCI than in CU (GFAP p = 0.811, NfL p = 0.909, p-tau181 p = 0.696). The plasma GFAP and p-tau181 levels negatively correlated with cognitive scores. Blood markers demonstrated higher performance in identifying AD than CU or MCI. Plasma p-tau181 displayed the highest diagnostic value for AD. Predictions of cognitive impairment were more robust when blood markers were combined with clinical indicators for AD (age, sex, body mass index, years of education, and APOE ε4 carrier status).
The expression of plasma GFAP, NfL, and p-tau181 increased in the AD continuum. Importantly, plasma p-tau181 could identify individuals with AD from the general population, with superior predictive performance when combined with age or sex.
Plasma biomarkers are useful screening indicators for early AD in Chinese adults.
尽管基于血液的生物标志物可用于检测早期阿尔茨海默病（AD），但人群差异会影响其在该疾病谱早期诊断中的临床价值。
探讨血浆生物标志物在中国人群中检测AD连续体不同阶段的潜力。
我们招募了113名来自深圳社区的成年人（53名认知未受损[CU]，45名轻度认知障碍[MCI]，15名AD患者）。我们使用单分子阵列技术检测胶质纤维酸性蛋白（GFAP）、神经丝轻链（NfL）和磷酸化tau181（p-tau181）的水平，并进行APOE基因分型。我们评估了血浆生物标志物与认知评分之间的关联，并使用受试者工作特征曲线来衡量早期AD诊断的性能。
AD患者血浆GFAP、NfL和p-tau181水平显著升高，MCI患者略高于CU患者（GFAP p = 0.811，NfL p = 0.909，p-tau181 p = 0.696）。血浆GFAP和p-tau181水平与认知评分呈负相关。血液标志物在识别AD方面比CU或MCI表现更好。血浆p-tau181对AD显示出最高的诊断价值。当血液标志物与AD的临床指标（年龄、性别、体重指数、受教育年限和APOE ε4携带者状态）相结合时，对认知障碍的预测更可靠。
血浆GFAP、NfL和p-tau181的表达在AD连续体中增加。重要的是，血浆p-tau181可以从普通人群中识别出AD患者，与年龄或性别相结合时具有更好的预测性能。
血浆生物标志物是中国成年人早期AD的有用筛查指标。
