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Circ Cardiovasc Imaging:冠状动脉钙化与痴呆症的风险有关吗?

2017-05-08 xing.T MedSci原创

由此可见,较高的基础CAC可以显著增加痴呆风险,独立于血管危险因素、ApoE -ε4和卒中。这一假设与血管损伤在痴呆症的发展中发挥作用是一致的。

研究表明血管损伤与痴呆之间存在相关性。然而,只有少数研究分析了亚临床血管疾病与痴呆症之间的纵向相关性。最近,心血管领域权威杂志Circulation-Cardiovascular Imaging上发表了一篇研究文章。研究人员在社区为基础的样本中评估了基础冠状动脉钙化(CAC),作为亚临床血管疾病的生物标志,是否与独立于血管危险因素和ApoE-ε4基因型的痴呆症发生之间的相关性。

研究人员分析了6293名参与了多民族动脉粥样硬化(MESA)研究的患者,研究之初(2000-2002年)参与者年龄为45-84岁,最初没有心血管疾病以及明显的认知缺陷。研究人员采用医院和死亡证明书上的国际统计分类的疾病和相关健康问题代码来确定痴呆症患者,调整血管危险因素、ApoEε4、有或没有排除临时卒中或心血管疾病后,根据CAC分类或log2[CAC+1]每增加一个标准差,采用Cox模型来计算风险比。

在中位随访时间为12.2年期间,研究人员观察到了271例痴呆患者。基础CAC与痴呆症风险之间存在正性分级相关性。在调整混杂因素后,与无CAC的患者相比, CAC评分从1-400、401-1000和≥1001其痴呆风险分别增加了23%、35%和71%(趋势P=0.026)。log2[CAC+1]每增加一个标准差痴呆风险增加24%(95%可信区间为8%-41%;P=0.002)。虽然这种相关性可部分被临时卒中/心血管疾病所解释,但在排除临时事件后,或不考虑基础年龄,这种相关性仍然具有显著性。

由此可见,较高的基础CAC可以显著增加痴呆风险,独立于血管危险因素、ApoE -ε4和卒中。这一假设与血管损伤在痴呆症的发展中发挥作用是一致的。

原始出处:

Akira Fujiyoshi,et al. Coronary Artery Calcium and Risk of Dementia in MESA (Multi-Ethnic Study of Atherosclerosis). Circ Cardiovasc Imaging. 2017.  https://doi.org/10.1161/CIRCIMAGING.116.005349

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    2017-10-06 Boyinsh
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    2017-08-17 quxin068
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    2017-05-10 Jackie Li

    学习

    0

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