알츠하이머병과 혈관성치매에서의 고감도 C반응성단백의 임상적 의의
A Clinical Significance of High-Sensitivity C-reactive Protein Level in Alzheimer’s Disease and Vascular Dementia
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: There is increasing evidence about inflammatory processes in the development of dementia. Therefore, inflammation has been believed to play a pivot role in cognitive decline, Alzheimer’s disease (AD), and vascular dementia. High-sensitivity C-reactive protein (hs-CRP) is a sensitive systemic marker of inflammation, and increased levels of hs-CRP are associated with inflammatory reactions. It is important to identify modifiable risk factors, which could be used in preventing or delaying the onset of dementia. Therefore, we studied to clarify a clinical role of hs-CRP in AD and VaD. Methods: This study population consisted of a sample of 102 patients with dementia (54 patients of AD and 48 patients of VaD) and 91 controls. We have investigated hs-CRP levels and cognitive function of each group. Cognitive function was evaluated with Mini-Mental State Examination (MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating (CDR) with Sum of Box and Activities of Daily Living (ADL). Results: All subjects with dementia showed higher hs-CRP levels than subjects without dementia. But, there was no significant difference of hs-CRP levels between patients with AD and those with VaD. The odds ratio of patients with AD and VaD by hs-CRP is 2.250 (95% Cl 1.670-3.032) for Alzheimer’s disease and 4.0 (95% Cl 2.451-6.529) for vascular dementia. Conclusions: The result of our study suggests the presence of inflammatory activity is related with dementia, not only AD known to degenerative disease but also VaD associated with cerebrovascular disease. However, we could suggest that dementia with cerebrovascular lesions is more related with inflammatory activity than AD.
Abstract
Background: There is increasing evidence about inflammatory processes in the development of dementia. Therefore, inflammation has been believed to play a pivot role in cognitive decline, Alzheimer’s disease (AD), and vascular dementia. High-sensitivity C-reactive protein (hs-CRP) is a sensitive systemic marker of inflammation, and increased levels of hs-CRP are associated with inflammatory reactions. It is important to identify modifiable risk factors, which could be used in preventing or delaying the onset of dementia. Therefore, we studied to clarify a clinical role of hs-CRP in AD and VaD. Methods: This study population consisted of a sample of 102 patients with dementia (54 patients of AD and 48 patients of VaD) and 91 controls. We have investigated hs-CRP levels and cognitive function of each group. Cognitive function was evaluated with Mini-Mental State Examination (MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating (CDR) with Sum of Box and Activities of Daily Living (ADL). Results: All subjects with dementia showed higher hs-CRP levels than subjects without dementia. But, there was no significant difference of hs-CRP levels between patients with AD and those with VaD. The odds ratio of patients with AD and VaD by hs-CRP is 2.250 (95% Cl 1.670-3.032) for Alzheimer’s disease and 4.0 (95% Cl 2.451-6.529) for vascular dementia. Conclusions: The result of our study suggests the presence of inflammatory activity is related with dementia, not only AD known to degenerative disease but also VaD associated with cerebrovascular disease. However, we could suggest that dementia with cerebrovascular lesions is more related with inflammatory activity than AD.
참고문헌 (28)
- Skoog I, "15-year longitudinal study of blood pressure and dementia", Lancet, 347, pp.1141~1145 (1996)
- Launer LJ, "Midlife blood pressure and dementia: the Honolulu-Asia aging study", Neurobiol Aging, 21, pp.49~55 (2000)
- Hofman A, "Athero-sclerosis apolipoprotein E, and prevalence of dementia and Alzheimers disease in the Rotterdam Study", Lancet, 349, pp.151~154 (1997)
- Ott A, "Grobbee DE, Hofman A. Atrial fibrillation and dementia in a popula-tion-based study. The Rotterdam Study", Stroke, 28, pp.316~321 (1997)
- Yoshitake T, "Incidence and risk factors of vascular dementia and Alzheimer’s disease in a defined elderly Japanese population: the Hisayama Study", Neurology, 45, pp.1161~1168 (1995)
- Ott A, "Diabetes mellitus and risk of dementia: the Rotterdam Study", Neurology, 53, pp.1937~1942 (1999)
- Gustafson D, "An 18-year follow-up of over-weight and risk of Alzheimer disease", Arch Intern Med, 163, pp.1524~1528 (2003)
- Honig LS, "Stroke and the risk of Alzheimer’s disease", Arch Neurol, 60, pp.1707~1712 (2003)
- Bassuk SS, "High sensitive C-reactive protein: clinical importance", Curr Probl Cardiol, 29, pp.439~493 (2004)
- Ridker PM, "Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events", N Engl J Med, 347, pp.1557~1565 (2002)
- Danesh J, "Low grade inflammation and coronary heart disease: prospective study and updated metaanalyses", BMJ, 321, pp.199~204 (2000)
- PraticoD, "Inflammatory hypotheses: novel mechanisms of Alzheimer’s neurodegeneration and new therapeutic targets?", Neurobiol Aging, 21, pp.441~445 (2000)
- Breteler MBB, "Vascular involvement in cognitive decline and dementia: epidemiologic evidence from the Rotterdam Study and the Rotterdam Scan Study", Ann N Y Acad Sci, 903, pp.457~465 (2000)
- Kuo HS, "Relation of C-reactive protein to stroke, cognitive disorders, and depression in the general population: systematic review and meta-analysis", Lancet Neurol, 4, pp.371~380 (2005)
- Schmidt R, "Early inflammation and dementia: a 25-year follow-up of the Honolulu-Asia Aging study", Ann Neurol, 52, pp.168~174 (2002)
- Ravaglia G, "Blood inflammatory markers and risk of dementia: the Conselice Study of brain aging", Neurobiol Aging, 28, pp.1810~1820 (2007)
- Nilsson K, "The lack of association between plasma homocysteine and inflammation in psychogeriatric patients", Dem Geriatr Cogn Disord, 14, pp.151~155 (2002)
- Nilsson K, "C-reactive protein: vascular risk marker in elderly patients with mental illness", Dem Geriatr Cogn Disord, 26, pp.251~256 (2008)
- Locascio JJ, "Plasma amyloid beta-protein and C-reactive protein in relation to the rate of progression of Alzheimer disease", Arch Neurol, 65, pp.776~778 (2008)
- Rost NS, "Plasma concentration of C-reactive protein and risk of ischemic stroke and transient ischemic attack: the Framingham study", Stroke, 32, pp.2575~2579 (2001)
- Yaffe K, "Inflammatory markers and cognition in well-functioning African-American and white elders", Neurology, 61, pp.76~80 (2003)
- McGeer EG, "The pentraxins: possible role in Alzheimer’s disease and other innate inflammatory diseases", Neurobiol Aging, 22, pp.843~848 (2001)
- Luchinger JA, "Cardiovascular risk factors and Alzheimer’s disease", Curr Atheroscler Rep, 6, pp.261~266 (2004)
- Casserly I, "Convergence of atherosclerosis and Alzheimer’s disease: inflammation, cholesterol, and misfolded proteins", Lancet, 363, pp.1139~1146 (2004)
- O’Bryant SE, "Decreased C-reactive protein levels in Alzheimer disease", J Ger Psych Neurol, 23, pp.49~53 (2010)
- White L, "Cerebrovascular pathology and dementia in autopsied Honolulu-Asia Aging Study participants", Ann NY Acad Sci, 977, pp.9~23 (2002)
- Kravitz BA, "Elevated C-reactive protein levels are associated with prevalent dementia in the oldest-old", Alzheimers Dement, 5, pp.318~323 (2009)
- Akiyama H, "Inflammation and Alzheimer’s disease", Neurobiol Aging, 21, pp.383~421 (2000)