生物标志物 生物标志物
Kristofer Harris1, Madison Shyer2, Paul E Schulz1
1John P. and Kathrine G. McGovern Medical School at UTHealth, Houston, TX, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
概括
未经治疗的高脂血症和糖尿病是阿尔茨海默病患者自然发生的粉样蛋白相关成像异常-血红蛋白 (ARIA-H) 的危险因素. 管理心血管健康可能会减少ARIA-H发病率.
科学领域:
- 神经学 神经学
- 老年学是一门学科.
- 放射学 放射学是一门学科.
背景情况:
- 与粉样蛋白相关的成像异常-hemosiderin (ARIA-H) 是在阿尔茨海默氏症 (AD) 中观察到的脑血管变化.
- 在AD患者中,ARIA-H可以自然发生,而不依赖于抗粉样蛋白免疫疗法.
- 确定自然发生的ARIA-H的危险因素对于患者管理至关重要.
研究的目的:
- 在阿尔茨海默病患者中探索自然发生的ARIA-H的相关风险因素.
- 区分自然发生的ARIA-H和与治疗相关的ARIA-H.
主要方法:
- 来自EXPEDITION 1随机对照试验的安慰剂组数据的分析.
- 纳入标准:基线和基线后的MRI数据与微出血信息.
- 统计分析人口统计,并发病,药物,认知得分,CSF,MRI和PET数据.
主要成果:
- 在460名患者中,有21名患者 (4.2%) 发生了事件ARIA-H.
- 确定了重要的危险因素:未治疗的高脂血症 (p=0.01),糖尿病诊断 (p=0.04),基线ARIA-H (p=0.04),以及较高的基线CSF t-Tau (p=0.03).
- APOE 4状态,年龄,抗凝固剂和抗血小板剂的使用与发生的ARIA-H没有显著相关.
结论:
- 未经治疗的高脂血症和糖尿病可能是AD中自然发生的ARIA-H的可修改风险因素.
- 优先考虑诸如高脂血症等心血管疾病的干预措施,可以降低ARIA-H的可能性.
- 建议使用EXPEDITION 2和3数据进行进一步验证,以指导临床决策.
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