The clinical significance of plasma clusterin and Aβ in the longitudinal follow-up of patients with Alzheimer’s disease
Abstract Background Clusterin and beta-amyloid (Aβ) are involved in the pathogenesis of Alzheimer’s disease (AD). The clinical significance of plasma clusterin and Aβ in AD progression remains controversial. Methods We recruited 322 patients with AD and 88 controls between August 2012 and June 2013....
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | Alzheimer’s Research & Therapy |
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| Online Access: | http://link.springer.com/article/10.1186/s13195-017-0319-x |
| _version_ | 1828494331195949056 |
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| author | Jung-Lung Hsu Wei-Ju Lee Yi-Chu Liao Shuu-Jiun Wang Jong-Ling Fuh |
| author_facet | Jung-Lung Hsu Wei-Ju Lee Yi-Chu Liao Shuu-Jiun Wang Jong-Ling Fuh |
| author_sort | Jung-Lung Hsu |
| collection | DOAJ |
| description | Abstract Background Clusterin and beta-amyloid (Aβ) are involved in the pathogenesis of Alzheimer’s disease (AD). The clinical significance of plasma clusterin and Aβ in AD progression remains controversial. Methods We recruited 322 patients with AD and 88 controls between August 2012 and June 2013. All participants were evaluated at baseline with a clinical assessment, Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) scales. Patients with AD were evaluated annually with the MMSE and Neuropsychiatric Inventory (NPI) scale during the 2-year follow-up period. The levels of plasma clusterin, Aβ1–40, and Aβ1–42 at baseline were analyzed to study the longitudinal changes in the patient scores on the MMSE and NPI during the follow-up period. Results Patients in the highest tertile of plasma clusterin levels showed significantly lower MMSE scores than those in the lowest tertile (p = 0.04). After adjustment for multiple covariates using the generalized estimating equation analysis, there was a significant decrease in the MMSE scores over the 2-year follow-up period among AD patients in the highest tertile of plasma clusterin levels compared with those in the lowest tertile (−2.09, 95% confidence interval (CI) = −3.67 to −0.51, p = 0.01). In apolipoprotein E (ApoE)4-positive AD patients, baseline measurements of the ratio of plasma Aβ1–42/Aβ1–40 in the highest tertile predicted an increase in NPI agitation/aggression scores over the 2-year follow-up period (6.06, 95% CI = 1.20–10.62, p = 0.02). Conclusions Plasma clusterin could serve as a biomarker for the severity of cognitive decline. Plasma Aβ in ApoE4-positive AD could predict long-term agitation/aggression symptoms. |
| first_indexed | 2024-12-11T11:54:18Z |
| format | Article |
| id | doaj.art-95ccb7a627f94fc4b5a39ed9f3c456a6 |
| institution | Directory Open Access Journal |
| issn | 1758-9193 |
| language | English |
| last_indexed | 2024-12-11T11:54:18Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Alzheimer’s Research & Therapy |
| spelling | doaj.art-95ccb7a627f94fc4b5a39ed9f3c456a62022-12-22T01:08:16ZengBMCAlzheimer’s Research & Therapy1758-91932017-11-019111110.1186/s13195-017-0319-xThe clinical significance of plasma clusterin and Aβ in the longitudinal follow-up of patients with Alzheimer’s diseaseJung-Lung Hsu0Wei-Ju Lee1Yi-Chu Liao2Shuu-Jiun Wang3Jong-Ling Fuh4Graduate Institute of Humanities in Medicine, Taipei Medical UniversityNeurological Institute, Taichung Veterans General HospitalFaculty of Medicine, National Yang-Ming University School of MedicineFaculty of Medicine, National Yang-Ming University School of MedicineFaculty of Medicine, National Yang-Ming University School of MedicineAbstract Background Clusterin and beta-amyloid (Aβ) are involved in the pathogenesis of Alzheimer’s disease (AD). The clinical significance of plasma clusterin and Aβ in AD progression remains controversial. Methods We recruited 322 patients with AD and 88 controls between August 2012 and June 2013. All participants were evaluated at baseline with a clinical assessment, Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) scales. Patients with AD were evaluated annually with the MMSE and Neuropsychiatric Inventory (NPI) scale during the 2-year follow-up period. The levels of plasma clusterin, Aβ1–40, and Aβ1–42 at baseline were analyzed to study the longitudinal changes in the patient scores on the MMSE and NPI during the follow-up period. Results Patients in the highest tertile of plasma clusterin levels showed significantly lower MMSE scores than those in the lowest tertile (p = 0.04). After adjustment for multiple covariates using the generalized estimating equation analysis, there was a significant decrease in the MMSE scores over the 2-year follow-up period among AD patients in the highest tertile of plasma clusterin levels compared with those in the lowest tertile (−2.09, 95% confidence interval (CI) = −3.67 to −0.51, p = 0.01). In apolipoprotein E (ApoE)4-positive AD patients, baseline measurements of the ratio of plasma Aβ1–42/Aβ1–40 in the highest tertile predicted an increase in NPI agitation/aggression scores over the 2-year follow-up period (6.06, 95% CI = 1.20–10.62, p = 0.02). Conclusions Plasma clusterin could serve as a biomarker for the severity of cognitive decline. Plasma Aβ in ApoE4-positive AD could predict long-term agitation/aggression symptoms.http://link.springer.com/article/10.1186/s13195-017-0319-xClusterinAlzheimer’s diseasePredictorProgression |
| spellingShingle | Jung-Lung Hsu Wei-Ju Lee Yi-Chu Liao Shuu-Jiun Wang Jong-Ling Fuh The clinical significance of plasma clusterin and Aβ in the longitudinal follow-up of patients with Alzheimer’s disease Alzheimer’s Research & Therapy Clusterin Alzheimer’s disease Predictor Progression |
| title | The clinical significance of plasma clusterin and Aβ in the longitudinal follow-up of patients with Alzheimer’s disease |
| title_full | The clinical significance of plasma clusterin and Aβ in the longitudinal follow-up of patients with Alzheimer’s disease |
| title_fullStr | The clinical significance of plasma clusterin and Aβ in the longitudinal follow-up of patients with Alzheimer’s disease |
| title_full_unstemmed | The clinical significance of plasma clusterin and Aβ in the longitudinal follow-up of patients with Alzheimer’s disease |
| title_short | The clinical significance of plasma clusterin and Aβ in the longitudinal follow-up of patients with Alzheimer’s disease |
| title_sort | clinical significance of plasma clusterin and aβ in the longitudinal follow up of patients with alzheimer s disease |
| topic | Clusterin Alzheimer’s disease Predictor Progression |
| url | http://link.springer.com/article/10.1186/s13195-017-0319-x |
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