Alzheimer’s Disease

阿尔茨海默病
  • 文章类型: Journal Article
    Ferroptosis,一种以脂质过氧化为特征的细胞死亡形式,涉及神经退行性疾病,如阿尔茨海默病(AD)。最近的研究表明,一线抗疟药青蒿素可有效对抗AD病理。在这项研究中,我们研究了青蒿素对神经元铁凋亡的保护作用及其机制。在海马HT22细胞中,用青蒿素剂量依赖性预处理,防止Erastin诱导的细胞死亡,EC50值为5.032µM,与铁凋亡抑制剂铁抑素-1相当(EC50=4.39µM)。我们证明了青蒿素(10μM)显着增加了HT22细胞中Nrf2的核易位并上调了SLC7A11和GPX4。Nrf2,SLC7A11或GPX4的敲除阻止了青蒿素的保护作用,表明其抗铁凋亡作用是由Nrf2-SLC7A11-GPX4途径介导的。分子对接和免疫共沉淀(Co-IP)分析表明,青蒿素与KEAP1竞争性结合,促进KEAP1-Nrf2复合物的解离并抑制Nrf2的泛素化。海马内注射咪唑-酮-伊拉斯汀(IKE)可引起小鼠的铁性凋亡,并伴有认知缺陷,这表明在NOR和NOL测试中对探索新物体和新物体位置的偏好较低。青蒿素(5,10mg/kg,i.p.)剂量依赖性地抑制IKE诱导的海马CA1区铁性凋亡,并改善学习和记忆障碍。此外,我们证明青蒿素逆转了Aβ1-42诱导的铁凋亡,HT22细胞中的脂质过氧化和谷胱甘肽消耗,原代海马神经元,和3×Tg小鼠通过KEAP1-Nrf2途径。我们的结果表明,青蒿素是一种新型的神经元铁凋亡抑制剂,靶向KEAP1激活Nrf2-SLC7A11-GPX4通路。
    Ferroptosis, a form of cell death characterized by lipid peroxidation, is involved in neurodegenerative diseases such as Alzheimer´s disease (AD). Recent studies have shown that a first-line antimalarial drug artemisinin is effective to counteract AD pathology. In this study, we investigated the protective effect of artemisinin against neuronal ferroptosis and the underlying mechanisms. In hippocampal HT22 cells, pretreatment with artemisinin dose-dependently protected against Erastin-induced cell death with an EC50 value of 5.032 µM, comparable to the ferroptosis inhibitor ferrostatin-1 (EC50 = 4.39 µM). We demonstrated that artemisinin (10 μM) significantly increased the nuclear translocation of Nrf2 and upregulated SLC7A11 and GPX4 in HT22 cells. Knockdown of Nrf2, SLC7A11 or GPX4 prevented the protective action of artemisinin, indicating that its anti-ferroptosis effect is mediated by the Nrf2-SLC7A11-GPX4 pathway. Molecular docking and Co-Immunoprecipitation (Co-IP) analysis revealed that artemisinin competitively binds with KEAP1, promoting the dissociation of KEAP1-Nrf2 complex and inhibiting the ubiquitination of Nrf2. Intrahippocampal injection of imidazole-ketone-Erastin (IKE) induced ferroptosis in mice accompanied by cognitive deficits evidenced by lower preference for exploration of new objects and new object locations in the NOR and NOL tests. Artemisinin (5, 10 mg/kg, i.p.) dose-dependently inhibited IKE-induced ferroptosis in hippocampal CA1 region and ameliorated learning and memory impairments. Moreover, we demonstrated that artemisinin reversed Aβ1-42-induced ferroptosis, lipid peroxidation and glutathione depletion in HT22 cells, primary hippocampal neurons, and 3×Tg mice via the KEAP1-Nrf2 pathway. Our results demonstrate that artemisinin is a novel neuronal ferroptosis inhibitor that targets KEAP1 to activate the Nrf2-SLC7A11-GPX4 pathway.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)是痴呆的最常见原因,以记忆丧失为特征,认知能力下降,人格改变,和各种神经症状。血脑屏障(BBB)损伤的作用,细胞外基质(ECM)异常,少突胶质细胞(ODCs)在AD中的功能障碍越来越受到关注,然而,详细的发病机制仍然难以捉摸。这项研究将AD患者脑血管系统的单细胞测序与全基因组关联分析相结合。它旨在阐明周细胞损伤背后的关联和潜在机制,ECM紊乱,和ODCs功能障碍在AD发病机制中的作用。最后,我们发现周细胞PI3K-AKT-FOXO信号通路异常可能参与AD的致病过程.这种全面的方法为AD的复杂病因提供了新的思路,并为其发病机理和治疗策略的高级研究开辟了道路。
    Alzheimer\'s disease (AD) is the most common cause of dementia, characterized by memory loss, cognitive decline, personality changes, and various neurological symptoms. The role of blood-brain barrier (BBB) injury, extracellular matrix (ECM) abnormalities, and oligodendrocytes (ODCs) dysfunction in AD has gained increasing attention, yet the detailed pathogenesis remains elusive. This study integrates single-cell sequencing of AD patients\' cerebrovascular system with a genome-wide association analysis. It aims to elucidate the associations and potential mechanisms behind pericytes injury, ECM disorder, and ODCs dysfunction in AD pathogenesis. Finally, we identified that abnormalities in the pericyte PI3K-AKT-FOXO signaling pathway may be involved in the pathogenic process of AD. This comprehensive approach sheds new light on the complex etiology of AD and opens avenues for advanced research into its pathogenesis and therapeutic strategies.
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  • 文章类型: Journal Article
    18F-氟代脱氧葡萄糖(18F-FDG)正电子发射断层扫描(PET)在阿尔茨海默病(AD)检查中很有价值。
    探讨18F-FDGPET在区分和分期AD以及脑葡萄糖代谢与认知功能和血管危险因素之间的关联方面的有效性。
    107名参与者包括19名轻度认知障碍(MCI),38轻度AD,24中度AD,15中重度AD,11个额颞叶痴呆(FTD)入组。利用视觉和基于体素的分析程序。认知条件,包括6个认知功能评分和7个单领域认知表现,和与高血压相关的血管危险因素,高脂血症,糖尿病,以年龄为协变量,肥胖与AD痴呆患者的糖代谢相关。
    18F-FDGPET有效地将AD与FTD区分开,也将MCI与AD亚型区分开,具有显着不同的低代谢(轻度AD除外)(身高阈值p<0.001,所有puncorr<0.05,以下相同)。认知功能得分,特别是迷你精神状态检查和蒙特利尔认知评估,与AD参与者的区域糖代谢显著相关(均p<0.05),而MCI患者单领域认知表现和血管危险因素与局部糖代谢显著相关(均p<0.05)。
    这项研究强调了18F-FDGPET在识别和分期AD中的重要作用。脑葡萄糖代谢与AD痴呆的认知状态和MCI的血管危险因素相关,表明18F-FDGPET可能有希望预测认知下降,并作为研究血管危险因素影响从MCI转化为AD的潜在机制的视觉框架。
    UNASSIGNED: 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is valuable in Alzheimer\'s disease (AD) workup.
    UNASSIGNED: To explore the effectiveness of 18F-FDG PET in differentiating and staging AD and associations between brain glucose metabolism and cognitive functions and vascular risk factors.
    UNASSIGNED: 107 participates including 19 mild cognitive impairment (MCI), 38 mild AD, 24 moderate AD, 15 moderate-severe AD, and 11 frontotemporal dementia (FTD) were enrolled. Visual and voxel-based analysis procedures were utilized. Cognitive conditions, including 6 cognitive function scores and 7 single-domain cognitive performances, and vascular risk factors linked to hypertension, hyperlipidemia, diabetes, and obesity were correlated with glucose metabolism in AD dementia using age as a covariate.
    UNASSIGNED: 18F-FDG PET effectively differentiated AD from FTD and also differentiated MCI from AD subtypes with significantly different hypometabolism (except for mild AD) (height threshold p < 0.001, all puncorr < 0.05, the same below). The cognitive function scores, notably Mini-Mental State Examination and Montreal Cognitive Assessment, correlated significantly with regional glucose metabolism in AD participants (all p < 0.05), whereas the single-domain cognitive performance and vascular risk factors were significantly associated with regional glucose metabolism in MCI patients (all p < 0.05).
    UNASSIGNED: This study underlines the vital role of 18F-FDG PET in identifying and staging AD. Brain glucose metabolism is associated with cognitive status in AD dementia and vascular risk factors in MCI, indicating that 18F-FDG PET might be promising for predicting cognitive decline and serve as a visual framework for investigating underlying mechanism of vascular risk factors influencing the conversion from MCI to AD.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)目前缺乏有效的改善疾病的治疗方法。最近的研究表明,铁性凋亡可能是一个潜在的治疗靶点。孟德尔随机化(MR)是一种广泛使用的用于识别新的治疗靶点的方法。
    利用遗传信息评估铁凋亡相关基因对AD风险的因果影响。
    从FerrDb获得564个铁凋亡相关基因。我们使用四个大脑数量性状基因座(QTL)和两个血液QTL数据集得出了这些基因的遗传工具变量。基于汇总数据的孟德尔随机化(SMR)和双样本MR方法用于评估铁凋亡相关基因对AD的因果影响。使用外部转录组数据集和AD的三转基因小鼠模型(3xTg-AD)来进一步验证通过MR分析鉴定的基因靶标。
    我们从GTEx中鉴定出17个潜在的AD风险基因靶标,13来自PsychENCODE,和22来自BrainMeta(SMRp<0.05和HEIDI检验p>0.05)。确定了六个与AD相关的重叠的铁凋亡相关基因,它可以作为潜在的治疗靶点(PEX10,CDC25A,EGFR,DLD,LIG3和TRIB3)。此外,我们进一步确定了血液组织和pQTL水平的风险基因或蛋白.值得注意的是,EGFR在外部转录组数据集和3xTg-AD模型中表现出显著的失调。
    这项研究提供了遗传证据,支持针对六个药物基因进行AD治疗的潜在治疗益处。特别是对于EGFR(通过转录组和3xTg-AD验证),这可能有助于优先考虑铁死亡领域的AD药物开发。
    UNASSIGNED: Alzheimer\'s disease (AD) currently lacks effective disease-modifying treatments. Recent research suggests that ferroptosis could be a potential therapeutic target. Mendelian randomization (MR) is a widely used method for identifying novel therapeutic targets.
    UNASSIGNED: Employ genetic information to evaluate the causal impact of ferroptosis-related genes on the risk of AD.
    UNASSIGNED: 564 ferroptosis-related genes were obtained from FerrDb. We derived genetic instrumental variables for these genes using four brain quantitative trait loci (QTL) and two blood QTL datasets. Summary-data-based Mendelian randomization (SMR) and two-sample MR methods were applied to estimate the causal effects of ferroptosis-related genes on AD. Using extern transcriptomic datasets and triple-transgenic mouse model of AD (3xTg-AD) to further validate the gene targets identified by the MR analysis.
    UNASSIGNED: We identified 17 potential AD risk gene targets from GTEx, 13 from PsychENCODE, and 22 from BrainMeta (SMR p < 0.05 and HEIDI test p > 0.05). Six overlapping ferroptosis-related genes associated with AD were identified, which could serve as potential therapeutic targets (PEX10, CDC25A, EGFR, DLD, LIG3, and TRIB3). Additionally, we further pinpointed risk genes or proteins at the blood tissue and pQTL levels. Notably, EGFR demonstrated significant dysregulation in the extern transcriptomic datasets and 3xTg-AD models.
    UNASSIGNED: This study provides genetic evidence supporting the potential therapeutic benefits of targeting the six druggable genes for AD treatment, especially for EGFR (validated by transcriptome and 3xTg-AD), which could be useful for prioritizing AD drug development in the field of ferroptosis.
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  • 文章类型: Journal Article
    背景:Isoorientin(ISO),黄酮C-糖苷,是糖原合酶激酶3β(GSK3β)底物竞争性抑制剂。ISO在治疗阿尔茨海默病(AD)方面具有潜力。GSK3β的过度活化可导致引起神经元损伤的神经炎症。小胶质细胞,作为中枢神经系统的固有免疫细胞,介导神经炎症。这里,我们研究了ISO对小胶质细胞活化以减轻神经炎症的影响.
    方法:观察ISO对脂多糖(LPS)刺激小鼠小胶质细胞BV2或SIM-A9细胞的作用。氯化锂(LiCl)是作为GSK3β抑制剂的阳性对照。通过ELISA和Griess测定法分析TNF-α和NO的释放,而COX-2、Iba-1、BDNF的表达,GSK3β,NF-κBp65,IκB,通过蛋白质印迹法检测Nrf2和HO-1。在SIM-A9细胞和分化的SH-SY5Y人神经母细胞瘤细胞共培养模型中,用MTS试验评价ISO对小胶质细胞介导的神经元损伤的影响。
    结果:ISO显著抑制TNF-α的产生(p<0.01),LPS诱导NO(p<0.001)、COX-2(p<0.01)和Iba-1(p<0.05)的表达,增加BDNF。在共培养中,SH-SY5Y的细胞活力被LPS抑制,这是由ISO预处理防止。ISO增加了p-GSK3β(Ser9)的表达,细胞质中的IκB和HO-1,与LPS组相比,细胞核中NF-κBp65降低,Nrf2升高。
    结论:ISO通过调节GSK3β减弱小胶质细胞的活化,NF-κB和Nrf2/HO-1信号通路发挥神经保护作用。
    Background: Isoorientin (ISO), a flavone C-glycoside, is a glycogen synthase kinase 3β (GSK3β) substrate-competitive inhibitor. ISO has potential in treatment of Alzheimer\'s disease (AD). An excessive activation of GSK3β can lead to neuroinflammation causing neuronal damage. Microglia cells, as resident immune cells of the central nervous system, mediate neuroinflammation. Here, we studied the effects of ISO on microglial activation to alleviate neuroinflammation.
    Methods: Effects of ISO were observed upon the stimulation of mouse microglia BV2 or SIM-A9 cells by lipopolysaccharide (LPS). Lithium chloride (LiCl) was the positive control as a GSK3β inhibitor. The release of TNF-α and NO were analyzed by ELISA and Griess assays, while expressions of COX-2, Iba-1, BDNF, GSK3β, NF-κB p65, IκB, Nrf2 and HO-1 were detected by Western blotting. In the co-culture model of SIM-A9 cells and differentiated SH-SY5Y human neuroblastoma cells, effects of ISO on microglia-mediated neuronal damage were evaluated with the MTS assay.
    Results: ISO significantly inhibited the production of TNF-α (p < 0.01), NO (p < 0.001) and the expression of COX-2 (p < 0.01) and Iba-1 (p < 0.05) induced by LPS, and increased BDNF. The cell viability of SH-SY5Y was inhibited by LPS in the co-culture, which was prevented by ISO pretreatment. ISO increased the expression of p-GSK3β (Ser9), IκB and HO-1 in the cytoplasm, decreased NF-κB p65 and increased Nrf2 in the nucleus compared with the LPS group.
    Conclusion: ISO attenuated the activation of microglia through regulating the GSK3β, NF-κB and Nrf2/HO-1 signaling pathways to exert neuroprotection.
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  • 文章类型: Journal Article
    背景:运动认知风险综合征(MCR)被定义为在没有运动障碍或痴呆的老年个体中存在缓慢的步态速度和主观认知能力下降。虽然一些研究表明MCR是痴呆前综合征,可能有助于预测认知障碍和痴呆的风险,并非所有研究都一致。这项研究的目的是全面总结和综合证据,以评估MCR与认知障碍和痴呆之间的关系。
    方法:遵循预先指定的协议,两位作者系统地搜索了PubMed,Embase,和Cochrane图书馆从开始到2024年8月19日,进行关于MCR与认知障碍和痴呆之间关联的观察性或随机研究。我们倾向于最大程度地调整风险和优势比,以确定认知障碍和痴呆的纵向和横断面风险。我们调查了异质性的潜在来源,并按大陆和认知结果的类型进行了敏感性和亚组分析。使用纽卡斯尔-渥太华量表(NOS)和建议分级评估证据质量,评估,发展和评价(等级)框架。
    结果:我们纳入了20项研究,包括1,206,782名参与者的组合队列,其中17项研究纳入定量分析。汇总分析显示,MCR患者患认知障碍和痴呆的风险高2.20倍。与对照组相比(RR=2.20;95CI=1.91-2.53)。这些发现在所有亚组分析中保持稳健,发表偏倚的敏感性分析和评估。
    结论:MCR可能被认为是长期认知障碍和痴呆的预测因素。在临床评估认知障碍和痴呆的风险时,应考虑到这一点,但需要进一步的研究才能使这种关联更加清晰。
    BACKGROUND: Motoric cognitive risk syndrome (MCR) is defined as the presence of slow gait-speed and subjective cognitive decline in older individuals without mobility disability or dementia. While some studies suggest that MCR is a pre-dementia syndrome and may help predict the risk of cognitive impairment and dementia, not all studies concur. The objective of this study is to comprehensively summarize and synthesize evidence to assess the association between MCR and cognitive impairment and dementia.
    METHODS: Following a pre-specified protocol, two authors systematically searched PubMed, Embase, and The Cochrane Library from inception to 19 August 2024 for observational or randomized studies pertaining to the association between MCR and cognitive impairment and dementia. We favoured maximally adjusted hazards and odds ratios to determine the longitudinal and cross-sectional risk of cognitive impairment and dementia. We investigated for potential sources of heterogeneity and also conducted sensitivity and subgroup analyses by continent and the type of cognitive outcome. The quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS) and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework.
    RESULTS: We included 20 studies comprising a combined cohort of 1,206,782 participants, of which 17 studies were included in the quantitative analysis. The pooled analysis outlined that individuals with MCR exhibited 2.20-fold higher risk of cognitive impairment and dementia, compared to controls (RR=2.20; 95%CI=1.91-2.53). These findings remained robust across all subgroup analyses, sensitivity analyses and assessments of publication bias.
    CONCLUSIONS: MCR may be considered a predictive factor for long-term cognitive impairment and dementia. This should be taken into consideration when clinically evaluating the risk of cognitive impairment and dementia but further research is required to lend greater clarity to this association.
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  • 文章类型: Journal Article
    脑铁稳态在维持生理条件下的脑发育和控制神经元功能中起着至关重要的作用。许多研究表明,脑铁稳态失衡与神经退行性疾病的发病机制密切相关,如阿尔茨海默病(AD)和帕金森病(PD)。最近的进展揭示了铁转运蛋白和调节分子在NDs的发病机理和治疗中的重要性。本文综述了脑铁过载及几种关键铁转运蛋白和调节蛋白在AD和PD中的异常表达的研究进展。强调这些分子在AD和PD发病机制中的病理作用,并强调了在AD和PD治疗中靶向这些铁转运蛋白和调节剂以恢复脑铁稳态的治疗前景。全面了解铁的病理生理作用,铁运输机和调节器,和它们在ND中的规定可能为更有针对性的治疗这些疾病的神经治疗策略提供新的治疗途径。
    Brain iron homeostasis plays a vital role in maintaining brain development and controlling neuronal function under physiological conditions. Many studies have shown that the imbalance of brain iron homeostasis is closely related to the pathogenesis of neurodegenerative diseases (NDs), such as Alzheimer\'s disease (AD) and Parkinson\'s disease (PD). Recent advances have revealed the importance of iron transporters and regulatory molecules in the pathogenesis and treatment of NDs. This review summarizes the research progress on brain iron overload and the aberrant expression of several key iron transporters and regulators in AD and PD, emphasizes the pathological roles of these molecules in the pathogenesis of AD and PD, and highlights the therapeutic prospects of targeting these iron transporters and regulators to restore brain iron homeostasis in the treatment of AD and PD. A comprehensive understanding of the pathophysiological roles of iron, iron transporters and regulators, and their regulations in NDs may provide new therapeutic avenues for more targeted neurotherapeutic strategies for treating these diseases.
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  • 文章类型: Journal Article
    (±)-ElodeoidionsA-L(1-12),从具有独特的线性或角6/6/6环核的金丝桃中分离出12对先前未描述的基于丝状酸的类黄酮类化合物。现代光谱技术,使用改进的Mosher方法和量子化学计算来识别1-12的计划者结构和构型。此外,预计1-12的潜在生物合成途径.此外,生物活性评估表明,1a,5a,和11b可以激活视黄醇X受体-α(RXRα)转录并增强ATP结合盒转运蛋白A1(ABCA1)蛋白的表达。荧光滴定分析表明1a可能与RXRα-LBD蛋白有直接相互作用,估计的Kd值为5.85μM。此外,分子对接研究证实了1a与RXRα的结合,并通过细胞热转移测定(CETSA)进一步验证。因此,化合物1a可以通过靶向RXRα和上调ABCA1蛋白的表达来促进β-淀粉样蛋白(Aβ)的清除,显示出作为抗阿尔茨海默氏症药物的希望。
    (±)-Elodeoidileons A-L (1-12), 12 pairs of previously undescribed filicinic acid based meroterpenoids were isolated from Hypericum elodeoides with unique linear or angular 6/6/6 ring core. Modern spectroscopic techniques, modified Mosher\'s method and quantum chemical calculations were used to identify the planner structures and configurations of 1-12. Additionally, the potential biosynthetic pathways for 1-12 were anticipated. Moreover, biological activity assessments suggested that 1a, 5a, and 11b could activate Retinoid X receptor-α (RXRα) transcription and enhance the ATP-binding cassette transporter A1 (ABCA1) protein\'s expression. Fluorescence titration assay suggested that 1a might have a direct interaction with the RXRα-LBD protein, with an estimated Kd value of 5.85 μM. Moreover, molecular docking study confirmed the binding of 1a to RXRα and further validated by cellular thermal shift assay (CETSA). Thus, compound 1a may promote β-amyloid (Aβ) clearance by targeting RXRα and upregulating the expression of the ABCA1 protein, showing promise as anti-Alzheimer\'s agent.
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  • 文章类型: Journal Article
    塑料产品的广泛接触和认知障碍患者数量的增加给社会带来了沉重的负担。
    本研究旨在调查中国老年人日常生活中塑料制品暴露与认知功能之间的关系。
    数据来自2023年宁夏老年人心理健康队列,包括4045名60岁及以上的参与者。使用简易精神状态检查量表评估认知功能。使用基于人群的塑料暴露问卷来计算塑料暴露得分(PES)。采用二元logistic回归分析PES与认知功能的关系,而限制性三次样条用于检查PES和认知功能之间的剂量反应关系。潜在剖面分析(LPA)被用来探索塑料暴露的潜在模式,采用logistic回归分析不同暴露模式与认知功能的关系。利用线性回归模型研究PES与认知功能不同维度之间的关系。
    在4045名参与者中,1915名个体被评估为轻度认知障碍(MCI)。在调整所有协变量后,PES(OR=1.04,95%CI1.02-1.06)与MCI风险显着相关,并表现出剂量-反应关系。LPA确定了两个潜在的塑料暴露类别,在使用塑料器具的组中观察到MCI的风险更高。
    这项研究表明,塑料暴露水平与MCI风险之间存在正相关,特别是那些经常使用塑料餐具的人。
    UNASSIGNED: The widespread exposure to plastic products and the increasing number of individuals with cognitive impairments have imposed a heavy burden on society.
    UNASSIGNED: This study aims to investigate the relationship between plastic product exposure in daily life and cognitive function in older Chinese individuals.
    UNASSIGNED: Data were obtained from the 2023 Ningxia Older Psychological Health Cohort, comprising 4045 participants aged 60 and above. Cognitive function was assessed using the Mini-Mental State Examination scale. A population-based plastic exposure questionnaire was used to calculate plastic exposure scores (PES). Binary logistic regression was employed to analyze the relationship between PES and cognitive function, while restricted cubic splines were used to examine the dose-response relationship between PES and cognitive function. Latent profile analysis (LPA) was employed to explore the potential patterns of plastic exposure, and logistic regression was used to investigate the relationship between different exposure patterns and cognitive function. A linear regression model was utilized to investigate the relationship between PES and different dimensions of cognitive function.
    UNASSIGNED: Among the 4045 participants, 1915 individuals were assessed with mild cognitive impairment (MCI). After adjusting for all covariates, PES (OR = 1.04, 95% CI 1.02-1.06) was significantly associated with the risk of MCI and exhibited a dose-response relationship. LPA identified two potential categories of plastic exposure, with a higher risk of MCI observed in the group using plastic utensils.
    UNASSIGNED: This study indicates a positive correlation between plastic exposure levels and MCI risk, particularly among individuals who frequently use plastic tableware.
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  • 文章类型: Journal Article
    识别可能发展为阿尔茨海默病(AD)的轻度认知障碍(MCI)的高危个体对于早期干预至关重要。
    本研究旨在开发和验证用于个性化评估MCI至AD转换的新型临床评分。
    分析了阿尔茨海默病神经影像学计划(ADNI)研究的数据。三分之二的MCI患者被随机分配到一个训练组(n=478),剩下的三分之一形成验证队列(n=239)。进行多变量逻辑回归以确定4年内与MCI至AD进展相关的因素。根据逻辑模型得出的回归系数制定预测评分,并在验证队列中进行测试。
    获得的脂质组学特征显示与疾病进展显著相关。MCI转换评分系统(范围从0到14分),由脂质组学签名和其他五个重要变量组成(载脂蛋白4,Rey听觉言语学习测试即时和延迟回忆,阿尔茨海默病评估量表延迟回忆测试,功能活动问卷,和AD信号的皮质厚度),是建造的。较高的转化评分与较高比例的患者转化为AD相关。评分系统在训练队列(AUC=0.879,Hosmer-Lemeshow检验的p=0.597)和验证队列(AUC=0.915,Hosmer-Lemeshow检验的p=0.991)中均显示出良好的区分和校准。风险分类获得了优异的敏感性(0.84)和特异性(0.75)。
    MCI-AD转换评分是预测MCI患者疾病进展风险的可靠工具。
    UNASSIGNED: Identifying high-risk individuals with mild cognitive impairment (MCI) who are likely to progress to Alzheimer\'s disease (AD) is crucial for early intervention.
    UNASSIGNED: This study aimed to develop and validate a novel clinical score for personalized estimation of MCI-to-AD conversion.
    UNASSIGNED: The data from the Alzheimer\'s Disease Neuroimaging Initiative (ADNI) study were analyzed. Two-thirds of the MCI patients were randomly assigned to a training cohort (n = 478), and the remaining one-third formed the validation cohort (n = 239). Multivariable logistic regression was performed to identify factors associated with MCI-to-AD progression within 4 years. A prediction score was developed based on the regression coefficients derived from the logistic model and tested in the validation cohort.
    UNASSIGNED: A lipidomics-signature was obtained that showed a significant association with disease progression. The MCI conversion scoring system (ranged from 0 to 14 points), consisting of the lipidomics-signature and five other significant variables (Apolipoprotein ɛ4, Rey Auditory Verbal Learning Test immediate and delayed recall, Alzheimer\'s Disease Assessment Scale delayed recall test, Functional Activities Questionnaire, and cortical thickness of the AD signature), was constructed. Higher conversion scores were associated with a higher proportion of patients converting to AD. The scoring system demonstrated good discrimination and calibration in both the training cohort (AUC = 0.879, p of Hosmer-Lemeshow test = 0.597) and the validation cohort (AUC = 0.915, p of Hosmer-Lemeshow test = 0.991). The risk classification achieved excellent sensitivity (0.84) and specificity (0.75).
    UNASSIGNED: The MCI-to-AD conversion score is a reliable tool for predicting the risk of disease progression in individuals with MCI.
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