阿尔茨海默病及相关病2025，Vol.8Issue(3)：175-181,7.DOI:10.3969/j.issn.2096-5516.2025.03.004
脑脊液生长相关蛋白43在阿尔茨海默病中的诊断及预测价值研究
The diagnostic and predictive value of cerebrospinal fluid growth-associated protein 43 in Alzheimer's disease base on Alzheimer's disease neuroimaging initiative
摘要
Abstract
Objective:Investigate the diagnostic value of cerebrospinal fluid(CSF)growth-associated protein 43(GAP-43)in AD and the predictive value of AD transition from mild cognitive impairment(MCI)to dementia through a cross-sectional and longitudinal observational study.Methods:787 subjects with CSF GAP-43 data were divided into normal group(n=247),MCI group(n=413)and dementia group(n=127)based on cognitive status.Kruskal-Wallis test was used to compare the differences of CSF GAP-43 between groups.Multiple logistic model was used to test the correlation between CSF GAP-43 and different cognitive states.The diagnostic efficacy of CSF GAP-43 level for AD was evaluated by receiver-operating curves(ROC)and the area under curves(AUC).The diagnostic efficacy of AD was compared with that of CSF core markers(Aβ,t-tau,p-tau).Patients with MCI were divided into stable MCI(sMCI)and progressive MCI(pMCI)according to whether they progressed to dementia within 5 years.Mann-Whitney u test was used to compare CSF GAP-43 between groups.Cox regression model was used to test the correlation between CSF GAP-43 and the progression of MCI to dementia.The predictive value of CSF GAP-43 levels in predicting MCI progression to dementia was evaluated by ROC curve.The association of CSF GAP-43 level with the risk of progression to dementia was evaluated using Kaplan-Meier survival curves.Results:The results of cross-sectional study showed that the level of CSF GAP-43 was significantly higher in the dementia group than in the normal group and the MCI group(P＜0.0001).CSF GAP-43 was an independent risk factor for the onset of AD dementia(P=0.002).The AUC of CSF GAP-43,Aβ,p-tau and t-tau for the diagnosis of AD were 0.64,0.68,0.64 and 0.63.Follow-up analysis showed that the level of CSF GAP-43 in pMCI patients was significantly higher than that in sMCI patients(P＜0.0001),and CSF GAP-43 was an independent risk factor for the progression of MCI to dementia(P=0.012).The AUC for CSF GAP-43 predicting MCI progression to dementia was 0.75(P＜0.0001,95%CI:0.69～0.80).The risk of progression to dementia was 3.45 times greater in MCI patients with high CSF GAP-43 levels than in MCI patients with low CSF GAP-43 levels(P＜0.0001,95%CI:2.17～5.43).Conclusion:CSF GAP-43 level can be used in the diagnosis of AD dementia,and its diagnostic efficacy is comparable to that of CSF core biomarkers(Aβ,t-tau,p-tau).CSF GAP-43 can predict the progression of MCI to dementia and is an independent risk factor for the progression of MCI to dementia.关键词
阿尔茨海默病/生长相关蛋白-43/脑脊液/生物标志物/轻度认知障碍Key words
Alzheimer's disease/Growth-associated protein 43/Cerebrospinal fluid(CSF)/Biomarker/Mild cognitive impairment分类
临床医学引用本文复制引用
艾伟平,向春晨,张玉梅..脑脊液生长相关蛋白43在阿尔茨海默病中的诊断及预测价值研究[J].阿尔茨海默病及相关病,2025,8(3):175-181,7.基金项目
北京市卫生健康委员会首都卫生发展科研专项项目(2022-11-2251) （2022-11-2251）
张家口市重点研发计划项目(2121185D) （2121185D）
