The ARIC-PET amyloid imaging study Brain amyloid differences by age, race, sex, and APOE
The ARIC-PET amyloid imaging study Brain amyloid differences by age, race, sex, and APOE
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DOI：
10.1212/wnl.0000000000002914
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发表时间：
2016-08-02
期刊：
影响因子：
9.9
通讯作者：
Mosley, Thomas H., Jr.
中科院分区：
文献类型：
--
作者：
Gottesman, Rebecca F.;Schneider, Andrea L. C.;Mosley, Thomas H., Jr.
目的：通过年龄、性别、种族、教育程度和APOE β（4）等位基因状态，评估无痴呆的社区队列中淀粉样蛋白沉积的差异。方法：从社区动脉粥样硬化风险纵向研究中招募329名年龄67-88岁的无痴呆参与者，在美国3个社区站点使用florbetapir PET成像（华盛顿县，马里兰州;福赛斯县，北卡罗来纳州;和杰克逊，密西西比）。计算标准化摄取值比率（SUVR）;将全球皮质SUVR >1.2评估为主要结局。年龄、种族、性别、教育水平和APOE β（4）等位基因数量在多变量模型中进行评估，包括血管危险因素、脑白色物质高密度和颅内总体积以及认知状态。在多变量模型中，受试者SUVR升高的几率随着年龄的增加而增加（比值比[OR] 1.63，95%置信区间[CI] 1.01-2.65/10岁）和黑人（OR 2.08，95% CI 1.23-3.51），但受教育程度无差异。每个等位基因都与SUVR升高的几率增加相关（OR 2.65，95%CI 1.61-4.39）。结论：在这个以社区为基础的无痴呆的队列中，氟倍他平的摄取与年龄和APOE基因型相关。在调整人口统计学、血管危险因素、认知状态、白色高信号体积和APOE基因型后，黑人与较高的SUVR相关，其效应大小接近APOE基因型（4）。需要在其他队列中复制这些结果，并且需要进一步研究这些观察到的种族差异的原因和后果。
Objective: To evaluate differences in amyloid deposition in a community-based cohort without dementia by age, sex, race, education, and APOE epsilon(4) allele status.Methods: Recruited from the longitudinal Atherosclerosis Risk in Communities study, 329 participants without dementia, ages 67-88 years, were imaged using florbetapir PET at 3 US community sites (Washington County, Maryland; Forsyth County, North Carolina; and Jackson, Mississippi). Standardized uptake value ratios (SUVRs) were calculated; global cortical SUVR >1.2 was evaluated as the primary outcome. Age, race, sex, education level, and number of APOE epsilon(4) alleles were evaluated in multivariable models including vascular risk factors, brain white matter hyperintensity and total intracranial volume, and cognitive status.Results: A total of 141 of the participants (43%) were black. In multivariable models, odds of elevated SUVR was increased in participants with increasing age (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.01-2.65 per 10 years of age) and black race (OR 2.08, 95% CI 1.23-3.51) but did not differ by educational level. Each epsilon(4) allele was associated with increased odds of elevated SUVR (OR 2.65, 95% CI 1.61-4.39).Conclusions: In this community-based cohort without dementia, florbetapir uptake is associated with older age and APOE genotype. Black race was associated with higher SUVR, after adjusting for demographics, vascular risk factors, cognitive status, white matter hyperintensity volume, and APOE genotype, with effect sizes nearing those seen for APOE epsilon(4). Replication of these findings is needed in other cohorts, and reasons for and consequences of these observed differences by race warrant further study.