唐氏综合征中体重指数与阿尔茨海默病病理及症状学关系的纵向研究。

Longitudinal study of body mass index in relation to Alzheimer's disease pathology and symptomatology in Down syndrome.

作者信息

Fleming Victoria L, Helsel Brian C, Ptomey Lauren T, Handen Benjamin L, Krinsky-McHale Sharon J, Hom Christy L, Zammit Matthew, Minhas Davneet, Luo Weiquan, Laymon Charles, Lee Joseph H, Lott Ira, Cohen Annie, Ances Beau M, Brickman Adam M, Pulsifer Margaret, Clare Isabel C H, Rosa H Diana, Lai Florencia, Harp Jordan, Schmitt Fredrick, Price Julie, Zaman Shahid H, Head Elizabeth, Mapstone Mark, Christian Bradley T, Okonkwo Ozioma, Hartley Sigan L

机构信息

Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA.

出版信息

Alzheimers Dement. 2025 Jun;21(6):e70387. doi: 10.1002/alz.70387.

DOI:10.1002/alz.70387

PMID:40545561

Abstract

INTRODUCTION

Weight loss has been linked to early Alzheimer's disease (AD) pathology, possibly through metabolic dysregulation. We examined changes in body mass index (BMI) in relation to AD biomarkers (amyloid beta [Aβ] and tau) and cognitive decline in adults with Down syndrome (DS). We hypothesized that BMI decline would track with early AD pathology and cognitive decline.

METHODS

Adults with DS (N = 467; M= 43.67 ± 10.06) completed one to four data cycles (≈16 months apart). Linear mixed models examined BMI change over time by age, positron emission tomography (PET) Aβ and tau, and changes in memory and dementia symptoms.

RESULTS

BMI declined with age-by-time (β = -0.014, p = 0.002) and baseline PET Aβ-by-time (β = -0.005, p = 0.002). On average, BMI decline began in the early 40s and was related to decline in memory and overall cognitive functioning.

DISCUSSION

Weight loss is associated with the presence of Aβ and cognitive decline in adults with DS. Longitudinal studies need to clarify directionality and biological mechanisms.

HIGHLIGHTS

Adults with Down syndrome (DS) are at an elevated risk for Down Syndrome assocaited Alzheimer's disease (DSAD). On average, adults with DS experience body mass index (BMI) decline beginning in their early 40s. Positron emission tomography amyloid beta deposition is associated with greater decline in BMI in adults with DS. Across time, AD-related memory declines are associated with BMI decline. BMI decline should be part of DSAD screening tools, as it is an important part of DSAD clinical disease expression.

摘要

引言

体重减轻与早期阿尔茨海默病（AD）病理相关，可能是通过代谢失调。我们研究了唐氏综合征（DS）成人的体重指数（BMI）变化与AD生物标志物（淀粉样β蛋白[Aβ]和tau蛋白）以及认知衰退之间的关系。我们假设BMI下降将与早期AD病理和认知衰退相关。

方法

DS成人（N = 467；平均年龄M = 43.67 ± 10.06）完成了一到四个数据周期（间隔约16个月）。线性混合模型研究了BMI随时间的变化，涉及年龄、正电子发射断层扫描（PET）Aβ和tau蛋白，以及记忆和痴呆症状的变化。

结果

BMI随年龄和时间下降（β = -0.014，p = 0.002），以及基线PET Aβ和时间下降（β = -0.005，p = 0.002）。平均而言，BMI下降始于40岁出头，且与记忆和整体认知功能下降有关。

讨论

体重减轻与DS成人中Aβ的存在和认知衰退相关。纵向研究需要阐明方向性和生物学机制。

重点

唐氏综合征（DS）成人患唐氏综合征相关阿尔茨海默病（DSAD）的风险较高。平均而言，DS成人从40岁出头开始体重指数（BMI）下降。正电子发射断层扫描淀粉样β蛋白沉积与DS成人中BMI更大幅度下降相关。随着时间推移，与AD相关的记忆衰退与BMI下降有关。BMI下降应成为DSAD筛查工具的一部分，因为它是DSAD临床疾病表现的重要组成部分。