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唐氏综合征患者的脂蛋白(a)水平:一个难题。

Lipoprotein(a) levels in Down syndrome: A conundrum.

作者信息

Rosas Herminia Diana, Lai Florence, Mercaldo Nathaniel

机构信息

Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA.

Center for Neuroimaging of Aging and Neurodegenerative Diseases, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts, USA.

出版信息

Alzheimers Dement. 2025 Jun;21(6):e70338. doi: 10.1002/alz.70338.

Abstract

INTRODUCTION

Lipoprotein a (Lp(a)) is a low-density lipoprotein (LDL)-like particle that has been associated with risk for vascular inflammation, atherogenesis, calcification, and thrombosis in the general population but is also a risk factor for Alzheimer disease (AD).

OBJECTIVE

The aim of this study was to conduct a retrospective study of lipoprotein a, Lp(a), levels in adults with Down syndrome (DS) and at risk for Alzheimer's disease (AD).

METHODS

Lp(a) serum concentrations were collected from 96 adults as part of a routine clinical assessment. A comprehensive medical chart review was conducted, including clinical laboratory values that could contribute to cognitive dysfunction (e.g., thyroid function tests, C-reactive protein(CRP), vitamin B12, lipid profiles, and vitamin D levels). Generalized linear regression models were constructed to quantify the relationship between each medical condition or laboratory value and Lp(a) level.

RESULTS

There was insufficient evidence for an increased risk for earlier age of onset of AD in those with elevated Lp(a) plasma levels (≥50 mg/dL).

DISCUSSION

Adults with DS may have unique neuro- and cardio- protective factors that deserve future investigation.

HIGHLIGHTS

Lipoprotein a (Lp(a)) elevations in Down syndrome (DS) are not associated with higher risk for Alzheimer's disease (AD). Lp(a) elevations are not associated with typical vascular risk factors in DS. Distinct neuro- and cardio- protective factors may play a role in DS that may provide novel insights.

摘要

引言

脂蛋白a(Lp(a))是一种类似低密度脂蛋白(LDL)的颗粒,在普通人群中与血管炎症、动脉粥样硬化、钙化和血栓形成风险相关,同时也是阿尔茨海默病(AD)的一个风险因素。

目的

本研究旨在对患有唐氏综合征(DS)且有患阿尔茨海默病(AD)风险的成年人的脂蛋白a(Lp(a))水平进行回顾性研究。

方法

作为常规临床评估的一部分,收集了96名成年人的Lp(a)血清浓度。进行了全面的病历审查,包括可能导致认知功能障碍的临床实验室值(如甲状腺功能测试、C反应蛋白(CRP)、维生素B12、血脂谱和维生素D水平)。构建广义线性回归模型以量化每种疾病状况或实验室值与Lp(a)水平之间的关系。

结果

没有足够的证据表明血浆Lp(a)水平升高(≥50mg/dL)的人患AD的发病年龄提前风险增加。

讨论

患有DS的成年人可能具有独特的神经和心脏保护因素,值得未来研究。

要点

唐氏综合征(DS)患者的脂蛋白a(Lp(a))升高与患阿尔茨海默病(AD)的较高风险无关。Lp(a)升高与DS患者的典型血管风险因素无关。独特的神经和心脏保护因素可能在DS中起作用,这可能提供新的见解。

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