Neurology：血液中神经酰胺或增加患阿尔茨海默氏症风险

血液中较高水平的特定脂肪--神经酰胺可能增加一个人发展罹患阿尔茨海默氏症的风险，根据一项在7月18日发表于Neurology杂志上的最新研究报道。

研究报告作者梅奥诊所流行病学教授说Michelle M. Mielke博士：我们的研究确定了这种生物标志物可以作为一个潜在的治疗或预防阿尔茨海默氏症的新靶标。
 
在这项研究中，科研人员收集99名年龄在70和7​​9之间的妇女血液测试中血清神经酰胺的水平，参试者被分为三组：高，中，低水平的神经酰胺三组。他们随后进行了长达9年的追访研究。研究发现在99名参加者中，那些生物标志物最高水平的妇女更容易患上阿尔茨海默氏病。中等水平生物标志物的妇女也容易患上该疾病，提高了近八倍。

Valory Pavlik博士说这些发现是重要的，因为确定准确早老年痴呆症的生物标志物可能有助于防止或延缓疾病。

未来每20年中，阿尔茨海默氏症的全球患病率将增加一倍。这无疑增加研究人员和医疗机构的负担，所以找出更有效的筛查、预防和治疗疾病策略迫在眉睫。

这项研究由国家老化研究所、国立神经疾病研究所等资助。

doi:10.1212/WNL.0b013e318264e380
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Serum ceramides increase the risk of Alzheimer disease

Michelle M. Mielke, PhD, Veera Vankata Ratnam Bandaru, PhD, Norman J. Haughey, PhD, Jin Xia, MS, et al.

Objectives: Previous studies have shown that high serum ceramides are associated with memory impairment and hippocampal volume loss, but have not examined dementia as an outcome. The aim of this study was to examine whether serum ceramides and sphingomyelins (SM) were associated with an increased risk of all-cause dementia and Alzheimer disease (AD).

Methods: Participants included 99 women without dementia aged 70–79, with baseline serum SM and ceramides, enrolled in a longitudinal population-based study and followed for up to 6 visits over 9 years. Baseline lipids, in tertiles, were examined in relation to all-cause dementia and AD using discrete time Cox proportional survival analysis. Lipids were analyzed using electrospray ionization tandem mass spectrometry.

Results: Twenty-seven (27.3%) of the 99 women developed incident dementia. Of these, 18 (66.7%) were diagnosed with probable AD. Higher baseline serum ceramides, but not SM, were associated with an increased risk of AD; these relationships were stronger than with all-cause dementia. Compared to the lowest tertile, the middle and highest tertiles of ceramide d18:1–C16:0 were associated with a 10-fold (95% confidence interval [CI] 1.2–85.1) and 7.6-fold increased risk of AD (95% CI 0.9–62.1), respectively. The highest tertiles of ceramide d18:1–C24:0 (hazard ratio [HR] = 5.1, 95% CI 1.1–23.6) and lactosylceramide (HR = 9.8, 95% CI 1.2–80.1) were also associated with risk of AD. Total and high-density lipoprotein cholesterol and triglycerides were not associated with dementia or AD.

Conclusions: Results from this preliminary study suggest that particular species of serum ceramides are associated with incident AD and warrant continued examination in larger studies.

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