Alzheimer Dementia:瑞金医院新发现痴呆患者,癌症风险如何?

2021-09-14 Freeman MedSci原创

AD患者可能有较低的几率患几种癌症,包括肺癌、前列腺癌和睾丸癌。

随着越来越多的老年人生活在社会中的人口趋势,人口中的疾病谱正在发生变化,非传染性疾病比传染性疾病影响更多的人。近几十年来,神经退行性疾病、癌症、血管疾病和中风(或脑血管疾病)是老年人的主要威胁。阿尔茨海默病(AD)是最普遍的神经退行性疾病之一,其特点是不可逆转的认知能力下降。据世界卫生组织(WHO)估计,2015年全球约有4600万人患有痴呆症,到2050年,这一数字可能接近1.52亿。

不幸的是,目前没有足够的有效疗法来治疗AD患者,而且该疾病的进展目前无法逆转。有许多与AD病理学和病理生理学有关的假说,例如,淀粉样β(Aβ)沉积和随后的级联导致突触损失,Tau蛋白过度磷酸化和随后的神经炎症,以及年龄依赖性的蛋白稳态损伤,但直到现在,科学家还没有就AD病因学达成共识

癌症,或称肿瘤,是全球第二大死亡原因。癌症是一种典型的增殖性疾病。癌症可能发生在人体的每个部位,有趣的是,癌症发生的区域偏好随着时间的推移而变化。对于65岁以上的人来说,肺癌、结直肠癌胃癌的发病率位居前列。

由于AD和癌症都经常发生在老年人身上,寻求AD和癌症风险之间的潜在联系似乎相当自然。众所周知,免疫系统功能紊乱在癌症的发病中起着重要作用,免疫细胞在早期阶段就会消灭癌细胞。另一方面,新出现的证据显示,神经炎症引发了AD的病理过程,对其产生了负面影响。

此外,大脑功能和肠道功能之间似乎存在着神秘的互动,特别是在病理状态下。微生物群-肠道-大脑轴的趋势吸引了研究人员对神经退行性疾病的关注。因此,人们对调查AD和消化道癌症的关联感到好奇。此外,有证据显示,高血糖会引发具有脂蛋白E(APOE)ε3/ε3基因型的中国成年人的认知能力下降,目前仍不清楚来自糖尿病对AD和癌症风险之间的关联有什么影响。

尽管许多观察性研究显示AD与癌症风险之间存在反向关系,但这些结果大多是在西方人群中调查的。此外,中国人口的疾病模式与西方人口的疾病模式有一定的不同。例如,帕金森病是另一种常见的神经退行性疾病,据报道,除了西方人群中帕金森病患者的恶性黑色素瘤发病率较高外,它与大多数癌症呈反比。相反,在东方人口中,发现PD患者的许多癌症类型的发病率增加。尽管中国人口是东亚人口和世界人口的最大组成部分之一,但在中国收集到的关于AD与癌症风险之间关系的证据有限。

藉此,瑞金医院陈生弟团队:探究了AD与患有或不患有糖尿病的癌症风险之间的潜在关联,并进一步澄清中国人口中的这种关联模式。此外,本研究为今后研究AD和癌症的共同和相互排斥机制提供了坚实的基础。

在这项回顾性队列研究中,他们采用多变量Cox比例危险回归分析来确定AD与各种癌症风险之间的相关性,以危险比(HRs)和95%置信区间(CIs)表示。

在8097名AD患者中,所有后续癌症的HR为0.822(95%CI,0.728-0.928;P=0.002)。其中,三种特定的癌症与AD有关:肺癌(HR,0.656;95% CI,0.494-0.871;P = .004),前列腺和睾丸癌(HR,0.414;95% CI,0.202-0.847;P = .016),以及淋巴瘤(HR,2.202;95% CI,1.005-4.826;P = .049)。

这个研究的重要意义在于发现了:AD患者可能有较低的几率患几种癌症,包括肺癌、前列腺癌和睾丸癌。同时,观察到AD与较高的淋巴瘤发病率之间存在正相关。


原文出处:
Ren R, Huang Q, Xu G, et al. Association between Alzheimer’s disease and risk of cancer: A retrospective cohort study in Shanghai, China. Alzheimer’s Dementia. Published online September 5, 2021:alz.12436. doi:10.1002/alz.12436

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1718059, encodeId=bf511e1805935, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Mon Apr 11 02:57:31 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1921323, encodeId=52851921323cd, content=<a href='/topic/show?id=6bfa58133ef' target=_blank style='color:#2F92EE;'>#新发现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58133, encryptionId=6bfa58133ef, topicName=新发现)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Sun Oct 03 03:57:31 CST 2021, time=2021-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2009109, encodeId=7d4a200910909, content=<a href='/topic/show?id=3ed8e121172' target=_blank style='color:#2F92EE;'>#痴呆患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71211, encryptionId=3ed8e121172, topicName=痴呆患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4aa106, createdName=crystal0562, createdTime=Fri Jun 17 09:57:31 CST 2022, time=2022-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052753, encodeId=60431052e5371, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1246283, encodeId=26971246283cb, content=老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=neuro.Dr, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1718059, encodeId=bf511e1805935, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Mon Apr 11 02:57:31 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1921323, encodeId=52851921323cd, content=<a href='/topic/show?id=6bfa58133ef' target=_blank style='color:#2F92EE;'>#新发现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58133, encryptionId=6bfa58133ef, topicName=新发现)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Sun Oct 03 03:57:31 CST 2021, time=2021-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2009109, encodeId=7d4a200910909, content=<a href='/topic/show?id=3ed8e121172' target=_blank style='color:#2F92EE;'>#痴呆患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71211, encryptionId=3ed8e121172, topicName=痴呆患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4aa106, createdName=crystal0562, createdTime=Fri Jun 17 09:57:31 CST 2022, time=2022-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052753, encodeId=60431052e5371, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1246283, encodeId=26971246283cb, content=老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=neuro.Dr, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1718059, encodeId=bf511e1805935, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Mon Apr 11 02:57:31 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1921323, encodeId=52851921323cd, content=<a href='/topic/show?id=6bfa58133ef' target=_blank style='color:#2F92EE;'>#新发现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58133, encryptionId=6bfa58133ef, topicName=新发现)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Sun Oct 03 03:57:31 CST 2021, time=2021-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2009109, encodeId=7d4a200910909, content=<a href='/topic/show?id=3ed8e121172' target=_blank style='color:#2F92EE;'>#痴呆患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71211, encryptionId=3ed8e121172, topicName=痴呆患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4aa106, createdName=crystal0562, createdTime=Fri Jun 17 09:57:31 CST 2022, time=2022-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052753, encodeId=60431052e5371, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1246283, encodeId=26971246283cb, content=老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=neuro.Dr, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1718059, encodeId=bf511e1805935, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Mon Apr 11 02:57:31 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1921323, encodeId=52851921323cd, content=<a href='/topic/show?id=6bfa58133ef' target=_blank style='color:#2F92EE;'>#新发现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58133, encryptionId=6bfa58133ef, topicName=新发现)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Sun Oct 03 03:57:31 CST 2021, time=2021-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2009109, encodeId=7d4a200910909, content=<a href='/topic/show?id=3ed8e121172' target=_blank style='color:#2F92EE;'>#痴呆患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71211, encryptionId=3ed8e121172, topicName=痴呆患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4aa106, createdName=crystal0562, createdTime=Fri Jun 17 09:57:31 CST 2022, time=2022-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052753, encodeId=60431052e5371, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1246283, encodeId=26971246283cb, content=老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=neuro.Dr, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=)]
    2021-09-15 junJUN

    老年人痴呆何药可用??

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1718059, encodeId=bf511e1805935, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Mon Apr 11 02:57:31 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1921323, encodeId=52851921323cd, content=<a href='/topic/show?id=6bfa58133ef' target=_blank style='color:#2F92EE;'>#新发现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58133, encryptionId=6bfa58133ef, topicName=新发现)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Sun Oct 03 03:57:31 CST 2021, time=2021-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2009109, encodeId=7d4a200910909, content=<a href='/topic/show?id=3ed8e121172' target=_blank style='color:#2F92EE;'>#痴呆患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71211, encryptionId=3ed8e121172, topicName=痴呆患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4aa106, createdName=crystal0562, createdTime=Fri Jun 17 09:57:31 CST 2022, time=2022-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052753, encodeId=60431052e5371, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1246283, encodeId=26971246283cb, content=老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=neuro.Dr, createdTime=Wed Sep 15 08:57:31 CST 2021, time=2021-09-15, status=1, ipAttribution=)]
    2021-09-15 neuro.Dr

    老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!

    0

相关资讯

Neurology : 痴呆患者,神经精神症状和认知功能长期如何变化?

NPS和认知症状在整个AD过程中都很普遍,但在疾病过程中表现出不同的演变

JAMA 子刊:身边有人听你“吐槽”有多重要?与脑容积甚至认知有关!

以支持性倾听为形式的社会支持与更大的认知恢复力有关,它独立地改变了总脑容量较低和认知功能较差之间的关联。

Alzheimer & Dementia:糖尿病、中心型肥胖与女性中年认知下降的关系

中年可能是干预心血管危险因素以预防或延迟晚年认知障碍和ADRD的关键时期。

JAMA Neurology:足球比赛,哪个位置的运动员更容易患神经退行性疾病?

神经退行性疾病风险,与非守门员位置高度相关

Alzheimer Dementia:认知功能减退,预测痴呆,哪个量表更有效?

FCSRT、流畅性任务和综合认知评分似乎是向痴呆症发展的良好认知标志。

拓展阅读

IJNS:基于生命历程模型的多领域干预可降低老年人痴呆的风险

基于生命历程模型的多领域干预是可行的,有可能降低中国高危老年人患痴呆症的风险,改善他们的认知功能。

ART:视网膜血管的变化有望为观测阿尔茨海默病进程提供一个窗口

视网膜血管测量并不能代表非痴呆个体的脑血管损伤,而鼻侧象限的VD与海马萎缩相关,与淀粉样蛋白状态无关。

Neurology:利用基于弥散的神经炎症成像技术研究阿尔茨海默病的白质神经炎症

WM神经炎症在AD临床症状出现之前就已发生改变,并且与淀粉样变性相互作用。

Nature子刊:与记忆力训练相比,瑜伽对老年痴呆高危妇女的认知和免疫学影响

KY 对 SCD 有临床和生物学上的益处,将认知的变化与瑜伽的抗炎作用联系起来。

BMJ子刊:心血管风险负担、痴呆症风险和大脑结构成像标记——英国生物数据库研究

心血管风险负担与痴呆风险的正相关关系也适用于主要的痴呆亚型。心血管风险负担与全因痴呆的关系在很大程度上与心血管疾病的发病和痴呆的遗传易感性无关。

IJNS:老年痴呆症患者营养不良患病率和营养不良风险

结果表明,大约三分之一的痴呆症老年人存在营养不良,近一半的老年人有营养不良的风险。

2022 欧洲共识:MCI和轻度痴呆初级阶段的诊断和治疗

意大利阿尔兹海默病专家组 · 2022-10-09

适合痴呆症患者的急救护理:老年急救护理应用研究网络范围审查和共识会议的结果

急性期后和长期护理学会(AMDA,The Society for Post-Acute and Long-Term Care Medicine) · 2022-08-01

痴呆及阿尔茨海默病进展要点简析

四川大学华西医院 · 2022-07-26