Prediction of Alzheimer's Disease Using Midregional Proadrenomedullin and Midregional Proatrial Natriuretic Peptide: A Retrospective Analysis of 134 Patients With Mild Cognitive Impairment

被引:25
|
作者
Buerger, Katharina [1 ,2 ,3 ]
Uspenskaya, Olga [4 ]
Hartmann, Oliver [5 ]
Hansson, Oskar [6 ]
Minthon, Lennart [6 ]
Blennow, Kaj [7 ]
Moeller, Hans-Juergen [1 ]
Teipel, Stefan J. [8 ,9 ]
Ernst, Andrea [5 ]
Bergmann, Andreas [5 ]
Hampel, Harald [10 ]
机构
[1] Univ Munich, Dementia Res Sect, D-80336 Munich, Germany
[2] Univ Munich, Memory Clin, Alzheimer Mem Ctr, Dept Psychiat,Geriatr Psychiat Branch, D-80336 Munich, Germany
[3] Univ Munich, Inst Stroke & Dementia Res, Klinikum Grosshadern, D-80336 Munich, Germany
[4] IM Sechenov Moscow Med Acad, Dept Neurol, Moscow, Russia
[5] BRAHMS Aktiengesell AG, Res Dept, Ctr Biotechnol, Berlin, Germany
[6] Lund Univ, Clin Memory Res Unit, Dept Clin Sci, Malmo, Sweden
[7] Gothenburg Univ, Inst Neurosci & Physiol, Dept Psychiat & Neurochem, Sahlgrenska Acad, Molndal, Sweden
[8] Univ Rostock, Dept Psychiat & Psychotherapy, Rostock, Germany
[9] DZNE, Rostock, Germany
[10] Goethe Univ, Dept Psychiat Psychosomat Med & Psychotherapy, Frankfurt, Germany
基金
爱尔兰科学基金会;
关键词
PRO-ADRENOMEDULLIN; VASCULAR RISK; PLASMA; PROGRESSION; DIAGNOSIS; PRECURSOR; DEMENTIA; TAU; BIOMARKERS; DESIGN;
D O I
10.4088/JCP.09m05872oli
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Objective: Development of biomarkers for early detection of Alzheimer's disease (AD) is a major clinical research goal. On the basis of the hypothesis that cardiovascular risk factors contribute to the pathogenesis of AD, we investigated whether the cardiovascular risk markers midregional proadrenomedullin (MR-proADM) and midregional proatrial natriuretic peptide (MR-proANP) predict a major clinical milestone, ie, conversion from predementia mild cognitive impairment (MCI) to manifest AD. Method: A group of 134 MCI patients, among 137 originally prospectively recruited at the memory disorder clinic at Malmo University Hospital, Malmo, Sweden, between July 1998 and June 2001, was clinically followed for 4-6 years. We determined whether plasma concentrations of MR-proADM and MR-proANP at baseline predicted time to conversion from MCI to clinically diagnosed AD (DSM-III-R). MCI was diagnosed according to Petersen criteria. Results: During follow-up, 41.8% of MCI patients remained cognitively stable, 42.5% converted to possible and probable AD, and 15.7% converted to other forms of dementia (MCI-other). MCI converters and MCI-other patients showed increased concentrations of MR-proANP and MR-proADM compared to the stable MCI patients (P=.0001). At a cutoff of 87 pmol/L, MR-proANP yielded a sensitivity of 73.7% and a specificity of 64.3% for predicting conversion to All. The survival analysis showed that higher values of MR-proANP and MR-proADM were associated with progression to AD. In a multivariate Cox regression model including known risk factors, MR-proANP and MR-proADM remained independent risk factors for conversion to AD for patients below the age of 72 years. Conclusions: Our study shows that plasma concentrations of MR-proANP and MR-proADM have predictive value in the progression from predementia MCI to clinical AD. Sensitivity was particularly high, which may recommend this test for first-stage screening in patients at risk for AD. J Clin Psychiatry 2011;72(4): 556-563 (C) Copyright 2010 Physicians Postgraduate Press, Inc.
引用
收藏
页码:556 / 563
页数:8
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