Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition.
Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition.
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DOI：
10.1001/jama.2017.3090
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发表时间：
2017-04-11
期刊：
影响因子：
--
通讯作者：
Mosley TH
中科院分区：
文献类型：
--
作者：
Gottesman RF;Schneider AL;Zhou Y;Coresh J;Green E;Gupta N;Knopman DS;Mintz A;Rahmim A;Sharrett AR;Wagenknecht LE;Wong DF;Mosley TH
中年血管危险因素与老年痴呆症有关;这些危险因素是否直接导致脑淀粉样蛋白沉积尚不清楚。确定中年血管危险因素是否与晚年脑淀粉样蛋白沉积相关，使用florbetapir正电子发射断层扫描（PET）测量。在3个美国社区（华盛顿县，MD;福赛斯县，NC;和杰克逊，MS）进行的前瞻性队列研究。在社区动脉粥样硬化风险（ARIC）-PET淀粉样蛋白成像研究中，346名无痴呆的参与者;自1987-1989年以来，使用florbetapir PET扫描（2011-2013）评价血管风险因素和标志物。ARIC基线（年龄45-64岁）的血管危险因素在多变量模型中进行评估，包括年龄、性别、种族、APOE基因型和教育水平。根据PET扫描计算标准化摄取值比（SUVR）;计算平均整体皮质SUVR。升高的florbetapir（定义为SUVR>1.2）是因变量。在322名基线时无痴呆且无中年血管风险因素缺失的参与者中（43%黑人，58%女性，平均年龄52岁），SUVR（164名（50.9%）参与者阳性）在>20年后（中位数随访23.5; IQR 23.0-24.3）当参与者67-88岁（平均76岁）时测量。中年体重指数（BMI）升高与SUVR升高相关（OR 2.06，95% CI 1.16，3.65）。在基线时，65名参与者没有血管风险因素，123名有一个，134名有两个或更多;更多的中年风险因素与随访时淀粉样蛋白SUVR升高相关，分别为30.8%（n=20），50.4%（n=62）和61.2%（n=82）。在调整后的模型中，与0个中年血管风险因素相比，与1个血管危险因素相关的SUVR升高的比值比为1.88（95% CI 0.95-3.72），为2.88（95% CI 1.46-5.69）对于2个或更多血管风险因素，未发现显著的种族与风险因素的相互作用。生活血管危险因素与晚年脑淀粉样蛋白无关：（2个或更多晚年血管危险因素与0相比：OR 1.66，95% CI 0.75-3.69）。中年血管危险因素的增加与淀粉样蛋白SUVR升高显著相关;这种相关性对晚年危险因素不显著。这些发现与血管疾病在阿尔茨海默病发展中的作用一致。
Midlife vascular risk factors have been associated with late-life dementia; whether these risk factors directly contribute to brain amyloid deposition is less well understood. To determine if midlife vascular risk factors are associated with late-life brain amyloid deposition, measured using florbetapir positron emission tomography (PET). Prospective cohort study in 3 U.S. communities (Washington County, MD; Forsyth County, NC; and Jackson, MS). 346 participants without dementia in the Atherosclerosis Risk in Communities (ARIC)-PET Amyloid Imaging Study; evaluation of vascular risk factors and markers since 1987-1989, with florbetapir PET scans (2011-2013). Vascular risk factors at ARIC baseline (ages 45-64) were evaluated in multivariable models including age, sex, race, APOE genotype, and educational level. Standardized Uptake Value Ratios (SUVR) were calculated from PET scans; a mean global cortical SUVR was calculated. Elevated florbetapir (defined at SUVR>1.2) was the dependent variable. In 322 participants without dementia and with nonmissing midlife vascular risk factors at baseline (43% black, 58% female, mean age 52), SUVR (positive in 164 (50.9%) of participants) was measured >20 years later (median followup 23.5; IQR 23.0-24.3) when participants were 67-88 (mean 76 y). Elevated body mass index midlife (BMI) was associated with elevated SUVR (OR 2.06, 95% CI 1.16, 3.65). At baseline, 65 participants had no vascular risk factors, 123 had one, and 134 had two or more; a higher number of midlife risk factors was associated with elevated amyloid SUVR at followup, 30.8% (n=20), 50.4% (n=62), and 61.2% (n=82), respectively. In adjusted models, compared to 0 midlife vascular risk factors, the odds ratio for elevated SUVR associated with 1 vascular risk factor was 1.88 (95% CI 0.95-3.72) and was 2.88 (95% CI 1.46-5.69) for 2 or more vascular risk factors No significant race by risk factor interactions were found. Late-life vascular risk factors were not associated with late-life brain amyloid: (2 or more late-life vascular risk factors compared to 0: OR 1.66, 95% CI 0.75-3.69). An increasing number of midlife vascular risk factors was significantly associated with elevated amyloid SUVR; this association was not significant for late-life risk factors. These findings are consistent with a role of vascular disease in the development of Alzheimer’s Disease.
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影响因子：
11.2
作者：
Landau, Susan M.;Mintun, Mark A.;Joshi, Abhinay D.;Koeppe, Robert A.;Petersen, Ronald C.;Aisen, Paul S.;Weiner, Michael W.;Jagust, William J.
通讯作者：
Jagust, William J.
影响因子：
4.8
作者：
Gupta A;Iadecola C
通讯作者：
Iadecola C
DOI：
10.1097/nen.0b013e31823ac627
发表时间：
2011-12
影响因子：
3.2
作者：
Marín-Padilla M;Knopman DS
通讯作者：
Knopman DS
影响因子：
105.7
作者：
Kivipelto, M;Helkala, EL;Nissien, A
通讯作者：
Nissien, A
影响因子：
120.7
作者：
Jansen, Willemijn J.;Ossenkoppele, Rik;Knol, Dirk L.;Tijms, Betty M.;Scheltens, Philip;Verhey, Frans R. J.;Visser, Pieter Jelle
通讯作者：
Visser, Pieter Jelle