Plasma Pro-Enkephalin A and Incident Cognitive Impairment: The Reasons for Geographic and Racial Differences in Stroke Cohort.
Plasma Pro-Enkephalin A and Incident Cognitive Impairment: The Reasons for Geographic and Racial Differences in Stroke Cohort.
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DOI：
10.1161/jaha.122.029081
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发表时间：
2023-06-06
影响因子：
5.4
通讯作者：
Cushman, Mary
中科院分区：
文献类型：
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作者：
Short, Samuel A. P.;Wilkinson, Katherine;Schulte, Janin;Renteria, Miguel Arce;Cheung, Katharine L.;Nicoli, Charles D.;Howard, Virginia J.;Cushman, Mary
心血管疾病是认知障碍的危险因素。有证据表明，循环中阿片类前脑啡肽A（PENK‐A）的浓度较低和较高与中风风险有关。我们研究了血浆PENK-A与认知障碍的关系。REGARDS（卒中地理和种族差异的原因）是一项前瞻性队列研究，纳入了2003年至2007年入组的30239名成人。在一项巢式病例对照研究中测量了462名在4.7年内发生认知障碍的参与者和556名对照者的基线PENK-A。按基线PENK‐A对混杂因素校正的Logistic回归和样条曲线估计认知损害的比值比（OR）。测试年龄、性别和种族关联差异的交互作用术语。病例组和对照组之间的基线PENK‐A相当。按性别和年龄分类，PENK‐A与认知障碍的相关性存在显著差异（校正后的P值分别为0.003和0.06）。在女性而非男性中，样条图显示，较高和较低的PENK-A与认知障碍的几率降低相关（第10和第90次随访与中位数的OR分别为0.65 [95%CI，0.43-0.96]和0.64 [95%CI，0.41-0.99]），年龄无差异。在≥65岁但不年轻的男性中，较高的PENK‐A与认知障碍的几率降低相关（第四与第一四分位数的OR为0.47 [95% CI，0.22-0.99]）;样条曲线未证实该模式。在特定亚组中，高水平和低水平的循环阿片类药物PENK‐A与未来认知障碍的几率降低相关。有必要进行更多的研究，以了解这种关联的生物学基础和观察到的性别差异。
Cardiovascular disease is a risk factor for cognitive impairment. Evidence links both lower and higher concentration of the circulating opioid pro‐enkephalin A (PENK‐A) with stroke risk. We studied the association of plasma PENK‐A with incident cognitive impairment. REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a prospective cohort study of 30 239 adults enrolled from 2003 to 2007. Baseline PENK‐A was measured in a nested case–control study of 462 participants who developed cognitive impairment over 4.7 years, and 556 controls. Logistic regression and spline plots adjusted for confounders estimated odds ratios (ORs) of cognitive impairment by baseline PENK‐A. Interaction terms tested for differences in associations by age, sex, and race. Baseline PENK‐A was comparable between cases and controls. There were significant differences in the association of PENK‐A with cognitive impairment by sex and age (adjusted P=0.003 and 0.06, respectively). In women but not men, spline plots showed that higher and lower PENK‐A were associated with decreased odds of cognitive impairment (ORs for 10th and 90th percentiles versus median, 0.65 [95% CI, 0.43–0.96] and 0.64 [95% CI, 0.41–0.99]), with no difference by age. In men ≥65 years of age but not younger men, higher PENK‐A was associated with decreased odds for cognitive impairment (OR for fourth versus first quartile 0.47 [95% CI, 0.22–0.99]); this pattern was not confirmed with spline plotting. High and low levels of circulating opioid PENK‐A were associated with decreased odds of future cognitive impairment in specific subgroups. Additional research is warranted to understand the biology underlying this association and the observed differences by sex.
DOI：
10.1016/j.jstrokecerebrovasdis.2021.106237
发表时间：
2022-03
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
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作者：
Short SA;Wilkinson K;Long DL;Judd S;Schulte J;Kissela BM;Howard G;Cushman M
通讯作者：
Cushman M