Nan Wang, Yixun Ma, Xiaoyan Liang, Wenxin Fa, Xunyao Tian, Cuicui Liu, Min Zhu, Na Tian, Keke Liu, Shi Tang, Lin Song, Lin Cong, Lu Dai, Hong Xu, Yongxiang Wang, Tingting Hou, Yifeng Du, Chengxuan Qiu
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Kidney function was assessed using estimated glomerular filtration rate (eGFR) based on serum creatinine level. Dementia, Alzheimer's disease (AD) and vascular dementia (VaD) were diagnosed according to the international criteria. Plasma biomarkers were measured using the SIMOA platform in a subsample (<i>n</i> = 1446). Data were analyzed using logistic, general linear, and mediation models.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of the 5715 participants, 306 were diagnosed with dementia, including 195 with AD and 100 with VaD. Impaired kidney function (eGFR <60 vs. ≥90 mL/min/1.73 m<sup>2</sup>) was associated with multivariable-adjusted odds ratios of 2.24 (95% confidence interval [CI] 1.44–3.46) for all-cause dementia, 1.85 (1.07–3.18) for AD, and 2.49 (1.16–5.22) for VaD. 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引用次数: 0
摘要
背景和目的：新近的证据表明，肾功能受损与老年人痴呆症有关，但人们对其关联的神经病理学途径仍然知之甚少。我们试图研究中国农村人口中肾功能与痴呆症和血浆生物标志物之间的关系：这项基于人群的研究使用了 "中国农村延迟痴呆和残疾多模式干预（MIND-China）"队列（2018 年 3 月至 9 月；n = 5715）的基线检查数据。肾功能根据血清肌酐水平采用估计肾小球滤过率（eGFR）进行评估。根据国际标准诊断痴呆、阿尔茨海默病（AD）和血管性痴呆（VaD）。使用 SIMOA 平台对子样本（n = 1446）中的血浆生物标志物进行了测量。数据采用逻辑模型、一般线性模型和中介模型进行分析：结果：在 5715 名参与者中，有 306 人被诊断为痴呆症，其中包括 195 名 AD 患者和 100 名 VaD 患者。肾功能受损（eGFR 2）与全因痴呆的多变量调整几率比为 2.24（95% 置信区间 [CI] 1.44-3.46），与 AD 的几率比为 1.85（1.07-3.18），与 VaD 的几率比为 2.49（1.16-5.22）。86）、神经丝轻链（β系数=10.62，95% CI 5.62-15.62）和总 tau（β系数=0.68，95% CI 0.44-0.91），以及较低的 Aβ42/Aβ40 比值（β系数=-4.11，95% CI -8.08--0.14）。中介分析表明，血浆总 tau 显著中介了肾功能受损与 AD 之间 21.76% 的关联（p 结论：肾功能受损与痴呆症的关联性很小：肾功能受损与中国农村老年人痴呆症和血浆生物标志物有关，与AD的关系部分由血浆神经变性生物标志物中介。
Association of dementia with impaired kidney function and plasma biomarkers: A population-based study
Background and Purpose
Emerging evidence has linked impaired kidney function with dementia in older adults, but the neuropathological pathways underlying their association remain poorly understood. We sought to examine the relationships of kidney function with dementia and plasma biomarkers in a Chinese rural population.
Methods
This population-based study used data from the baseline examination of the Multimodal Interventions to Delay Dementia and Disability in rural China (MIND-China) cohort (March–September 2018; n = 5715). Kidney function was assessed using estimated glomerular filtration rate (eGFR) based on serum creatinine level. Dementia, Alzheimer's disease (AD) and vascular dementia (VaD) were diagnosed according to the international criteria. Plasma biomarkers were measured using the SIMOA platform in a subsample (n = 1446). Data were analyzed using logistic, general linear, and mediation models.
Results
Of the 5715 participants, 306 were diagnosed with dementia, including 195 with AD and 100 with VaD. Impaired kidney function (eGFR <60 vs. ≥90 mL/min/1.73 m2) was associated with multivariable-adjusted odds ratios of 2.24 (95% confidence interval [CI] 1.44–3.46) for all-cause dementia, 1.85 (1.07–3.18) for AD, and 2.49 (1.16–5.22) for VaD. In the biomarker subsample, impaired kidney function was significantly associated with higher plasma amyloid-β (Aβ)40 (β-coefficient = 54.36, 95% CI 43.34–65.39), Aβ42 (β-coefficient = 3.14, 95% CI 2.42–3.86), neurofilament light chain (β-coefficient = 10.62, 95% CI 5.62–15.62), and total tau (β-coefficient = 0.68, 95% CI 0.44–0.91), and a lower Aβ42/Aβ40 ratio (β-coefficient = −4.11, 95% CI −8.08 to −0.14). The mediation analysis showed that plasma total tau significantly mediated 21.76% of the association between impaired kidney function and AD (p < 0.05).
Conclusion
Impaired kidney function is associated with dementia and plasma biomarkers among rural-dwelling older Chinese adults, and the association with AD is partly mediated by plasma biomarkers for neurodegeneration.
期刊介绍：
The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).
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