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[P3–249]: LOW HEMOGLOBIN LEVEL IS ASSOCIATED WITH BRAIN MICROSTRUCTURAL INTEGRITY IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Author(s) -
Sedaghat Sanaz,
Burns Christine,
Jack Clifford R.,
Reid Robert I.,
Vemuri Prashanthi,
Murray Anne
Publication year - 2017
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.06.1462
Subject(s) - white matter , fractional anisotropy , kidney disease , medicine , hemoglobin , diffusion mri , anemia , cystatin c , brain size , cardiology , pathology , gastroenterology , renal function , magnetic resonance imaging , radiology
Background:Plasma amyloid beta (Ab1) levels are increasingly studied as a low cost and accessible potential marker of cognitive impairment and dementia. However, it remains underexplored whether plasma Ab1 levels relate to vascular brain disease and cognition in a preclinical-phase. We examined the association of plasma Ab1 levels (i.e. Ab1-38, 40 and 42) with markers of cerebral small vessel disease (SVD) and cognition in a large population-based setting. Methods:We analyzed plasma Ab1 levels in 1202 subjects from two cohorts of the Rotterdam study [older cohort (mean age:72.5 years, 51% women) and younger cohort (mean age:58.7 years, 54% women)]. Markers of SVD [lacunes, white matter hyperintensity (WMH) volume] were assessed on brain MRI (1.5T). Cognition was assessed by a detailed neuropsychological battery. In each cohort, the association of Ab1 levels with SVD and cognition was performed using regression models. Estimates were then pooled across cohorts using inverse variance meta-analysis with fixed effects. All models were adjusted for age, sex, education, mean arterial blood pressure, total cholesterol, diabetes, Apolipoprotein ε4 carrier, smoking and presence of other SVD marker. Results:Higher levels of plasma Ab1-38, 40 and 42 were associated with increasing lacunar counts [Ab1-38 Rate ratios (RR)1⁄4 1.41;95%Confidence Interval (CI),1.24-1.59], [Ab1-40 RR1⁄41.42; 95%CI, 1.25-1.61], [Ab1-42 RR1⁄41.26; 95%CI,1.12-1.42]. Moreover, higher levels of Ab1-38 and 40 were significantly associated with higher WMH volumes. With regards to cognition, a higher level of Ab1-38 was associated with worse performance on memory tests i.e. delayed recall [mean difference in scores (b) 1⁄4 -0.28; 95%CI, -0.45 to -0.11, p1⁄40.002] and recognition [b1⁄4 -0.22; 95%CI, -0.34 to -0.10, p1⁄4<0.001]. Similarly, a higher level of Ab1-40 was also associated with worse performance on memory test, i.e. recognition [b1⁄4 -0.20; 95%CI, -0.32 to -0.08, p1⁄40.001]. Conclusions:Higher plasma levels of Ab1-38, 40 and 42 were associated with subclinical markers of vascular disease. Moreover, Ab1-38 and 40 were linked to worse performance on memory tests. Plasma Ab1 levels thus, mark the presence of vascular brain pathology. Future studies should examine whether inclusion of novel plasma Ab1-38 levels as an additional biomarker can provide further information on microvascular damage in the brain.