Reduced risk of incident AD with elective statin use in a clinical trial cohort
Reduced risk of incident AD with elective statin use in a clinical trial cohort
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DOI：
10.2174/156720508785132316
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发表时间：
2008-08-01
影响因子：
2.1
通讯作者：
Liebsack, Carolyn
中科院分区：
文献类型：
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作者：
Sparks, D. Larry;Kryscio, Richard J.;Liebsack, Carolyn
据报道，他汀类药物可降低阿尔茨海默病（AD）的风险并在治疗中获益。参加随机对照试验的个体被允许选择性使用他汀类药物，该试验测试两种抗炎药用于AD的一级预防（阿尔茨海默病抗炎预防试验; ADAPT）。我们的目的是评估他汀类药物的使用是否与ADAPT参与者中AD事件风险降低相关。在主要的ADAPT研究中，每年对参与者的胆固醇水平和认知状态进行评估。如果注意到认知障碍，则进行痴呆评估。轻度认知功能障碍（MCI）或AD的发作作为本次评价的日期。在入组后6个月内分析至发作时间。在不了解ADAPT中主要治疗分配的情况下，根据参与者自我报告的降脂药（LLA）使用情况对参与者进行分组。在目前的辅助ADAPT研究中，我们发现在调整年龄、性别、教育和载脂蛋白E（ApoE）基因型后，选择性他汀类药物使用与AD事件风险显著降低相关。当比较所有LLA使用（他汀类和非他汀类LLA）与非LLA使用时，结果相似。与非LLA使用者相比，他汀类药物使用者的胆固醇水平较低，但MMSE评分相当。这些数据表明，他汀类药物治疗可能有利于降低AD的风险。
Statins have been reported to reduce the risk and be of benefit in the treatment of Alzheimer's disease (AD). Individuals enrolling in the randomized controlled trial testing two anti-inflammatory agents for primary prevention of AD (Alzheimer's Disease Anti-inflammatory Prevention Trial; ADAPT) were allowed the elective use of statins. Our objective was to assess whether statin use is associated with reduced risk of incident AD among ADAPT participants. In primary ADAPT study, participants were assessed annually for cholesterol levels and cognitive status. If impairment in cognition was noted, a dementia evaluation was performed. Onset of mild cognitive impairment (MCI) or AD was taken as the date of this evaluation. Time-to-onset was analyzed in six-month intervals following enrollment. Without knowledge of primary treatment assignment in ADAPT, participants were grouped by their self-reported use of lipid-lowering agents (LLA). In the current ancillary ADAPT study we found that elective statin use was associated with significantly reduced risk of incident AD after adjustment for age, gender, education and Apolipoprotein E (ApoE) genotype. The findings were similar when comparing all LLA use (statin and non-statin LLA) to non-LLA use. Cholesterol levels were lower among statin users compared with non-LLA users, but the MMSE scores were equivalent. The data suggest that statin therapy may be of benefit in reducing the risk of AD.