Plasma amyloid-β as a predictor of dementia and cognitive decline: a systematic review and meta-analysis.
Plasma amyloid-β as a predictor of dementia and cognitive decline: a systematic review and meta-analysis.
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DOI：
10.1001/archneurol.2011.1841
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发表时间：
2012-07
影响因子：
--
通讯作者：
Grodstein, Francine
中科院分区：
文献类型：
--
作者：
Koyama, Alain;Okereke, Olivia I.;Yang, Ting;Blacker, Deborah;Selkoe, Dennis J.;Grodstein, Francine
阿尔茨海默病的临床前预测是重要的，是有效干预的关键。淀粉样β-肽的血浆水平一直是血液生物标志物文献的主要关注点，但迄今为止的研究在设计、测定方法和样本量方面各不相同，因此难以容易地解释总体数据。对相关前瞻性研究进行系统回顾和荟萃分析，以确定血浆淀粉样蛋白β水平是否可以预测痴呆、阿尔茨海默病和认知能力下降的发生。检索了PubMed、EMBASE和PsycInfo数据库中1995年至2011年间发表的前瞻性研究。选定的研究包括测量至少一种相关血浆淀粉样β物质（Aβ40、Aβ42、Aβ42：Aβ40比值）并报告对痴呆、阿尔茨海默病或认知变化的效应估计的研究。使用标准化提取表，提取关于受试者信息、暴露和结局的适当研究参数。使用随机效应模型生成汇总风险比和95%置信区间，比较每个血浆指标的底部与顶部分位数。13项研究（共10，303例受试者）符合荟萃分析的入选标准。较低的Aβ42：Aβ40比值与阿尔茨海默病（RR=1.60，95%CI = 1.04，2.46; p=0.03）和痴呆（RR=1.67，95%CI = 1.02，2.75; p=0.04）的发生显著相关。两种汇总估计值均存在显著异质性，无法用参与者的年龄、性别分布、研究的随访时间或发表年份来解释。单独的Aβ40和Aβ42血浆水平与任一结局均无显著相关性。总体而言，文献表明血浆Aβ42：Aβ40比值可预测阿尔茨海默病和痴呆的发生。然而，荟萃分析中的显著异质性强调了需要对作为临床前生物标志物的血浆淀粉样蛋白β水平进行实质性的进一步研究。
Preclinical prediction of Alzheimer’s disease is important, critical to effective intervention. Plasma levels of amyloid β-peptides have been a principal focus of the growing literature on blood-based biomarkers, but studies to date have varied in design, assay methods and sample size, making it difficult to readily interpret the overall data. To conduct a systematic review and meta-analysis of relevant prospective studies in order to determine if plasma amyloid β levels may predict development of dementia, Alzheimer’s disease, and cognitive decline. Prospective studies published between 1995 and 2011 indexed in the PubMed, EMBASE, and PsycInfo databases were searched. Selected studies included those measuring at least one relevant plasma amyloid β species (Aβ40, Aβ42, Aβ42:Aβ40 ratio) and reporting an effect estimate for dementia, Alzheimer’s disease, or cognitive change. Using a standardized extraction form, appropriate study parameters on subject information, exposure, and outcome were extracted. Random effects models were utilized to generate summary risk ratios and 95% confidence intervals, comparing the bottom versus top quantile for each plasma measure. Thirteen studies with a total of 10,303 subjects met inclusion criteria for meta-analysis. Lower Aβ42:Aβ40 ratios were significantly associated with development of Alzheimer’s disease (summary RR=1.60, 95% CI=1.04,2.46; p=0.03) and dementia (RR=1.67 95% CI=1.02,2.75; p=0.04). Significant heterogeneity was found for both summary estimates, which could not be explained by participants’ age, sex distribution, the study’s follow-up time, or year of publication. Plasma levels of Aβ40 and Aβ42 alone were not significantly associated with either outcome. Overall, the literature indicates that plasma Aβ42:Aβ40 ratios predict development of Alzheimer’s disease and dementia. However, significant heterogeneity in the meta-analysis underlines the need for substantial further investigation of plasma amyloid β levels as a preclinical biomarker.
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DOI：
10.1136/jnnp.2010.205757
发表时间：
2010-10
期刊：
Journal of neurology, neurosurgery, and psychiatry
影响因子：
--
作者：
Seppälä TT;Herukka SK;Hänninen T;Tervo S;Hallikainen M;Soininen H;Pirttilä T
通讯作者：
Pirttilä T
DOI：
10.1073/pnas.0805902105
发表时间：
2008-09-16
影响因子：
11.1
作者：
Schupf, Nicole;Tang, Ming X.;Mayeux, Richard
通讯作者：
Mayeux, Richard
影响因子：
5
作者：
GREENLAND, S;LONGNECKER, MP
通讯作者：
LONGNECKER, MP
影响因子：
7.2
作者：
Blasko, Imrich;Kemmler, Georg;Fischer, Peter
通讯作者：
Fischer, Peter
影响因子：
9.9
作者：
Lopez, O. L.;Kuller, L. H.;DeKosky, S. T.
通讯作者：
DeKosky, S. T.