Amyloid PET Imaging in Self-Identified Non-Hispanic Black Participants of the Anti-Amyloid in Asymptomatic Alzheimer's Disease (A4) Study
Amyloid PET Imaging in Self-Identified Non-Hispanic Black Participants of the Anti-Amyloid in Asymptomatic Alzheimer's Disease (A4) Study
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DOI：
10.1212/wnl.0000000000011599
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发表时间：
2021-03-16
期刊：
影响因子：
9.9
通讯作者：
Mormino, Elizabeth C.
中科院分区：
文献类型：
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作者：
Deters, Kacie D.;Napolioni, Valerio;Mormino, Elizabeth C.
目的检验在无症状阿尔茨海默病(A4)研究中筛选抗淀粉样蛋白(A4)研究的认知正常(CN)个体的淀粉样蛋白PET在自我识别的非西班牙裔白人和黑人(NHW和NHB)组中是否存在差异。方法：我们检查了3689名NHW和144名NHB参与者，他们通过了A4研究的初步筛查并接受了淀粉样蛋白PET检查。对年龄、性别、apoE epsilon 4和apoE epsilon 2等位基因个数进行控制的Logistic回归(二分组法)和线性回归法(连续值)检验种族对淀粉样蛋白PET的影响。淀粉样蛋白和基因决定的祖先(反映非洲、南亚、东亚、美洲和欧洲人口)之间的关联在NHB组中进行了测试。结果与NHW参与者相比，NHB参与者的淀粉样蛋白阳性率和持续淀粉样蛋白水平较低。在APOE epsilon 4组中，这种对淀粉样蛋白的种族效应最强。在NHB参与者中，非洲血统比例较低的人淀粉样蛋白较高。与NHW参与者相比，NHB参与者没有通过初始筛查的比例更大，这表明在A4 PET数据中与种族相关的潜在偏见来源。结论：在通过A4研究初始资格标准的自认为NHB参与者中观察到淀粉样蛋白减少。这项工作强调了在祖先不同的样本中调查AD生物标志物的重要性，以及在AD预防试验中仔细考虑研究资格标准的必要性。
ObjectiveTo examine whether amyloid PET in cognitively normal (CN) individuals screened for the Anti-Amyloid in Asymptomatic Alzheimer's Disease (A4) study differed across self-identified non-Hispanic White and Black (NHW and NHB) groups.MethodsWe examined 3,689 NHW and 144 NHB participants who passed initial screening for the A4 study and underwent amyloid PET. The effect of race on amyloid PET was examined using logistic (dichotomous groups) and linear (continuous values) regression controlling for age, sex, and number of APOE epsilon 4 and APOE epsilon 2 alleles. Associations between amyloid and genetically determined ancestry (reflecting African, South Asian, East Asian, American, and European populations) were tested within the NHB group. Potential interactions with APOE were assessed.ResultsNHB participants had lower rates of amyloid positivity and lower continuous amyloid levels compared to NHW participants. This race effect on amyloid was strongest in the APOE epsilon 4 group. Within NHB participants, those with a lower percentage of African ancestry had higher amyloid. A greater proportion of NHB participants did not pass initial screening compared to NHW participants, suggesting potential sources of bias related to race in the A4 PET data.ConclusionReduced amyloid was observed in self-identified NHB participants who passed initial eligibility criteria for the A4 study. This work stresses the importance of investigating AD biomarkers in ancestrally diverse samples as well as the need for careful consideration regarding study eligibility criteria in AD prevention trials.