Advanced

Prediction of Alzheimer's Disease Using Midregional Proadrenomedullin and Midregional Proatrial Natriuretic Peptide: A Retrospective Analysis of 134 Patients With Mild Cognitive Impairment

Buerger, Katharina; Uspenskaya, Olga; Hartmann, Oliver; Hansson, Oskar LU ; Minthon, Lennart LU ; Blennow, Kaj; Moeller, Hans-Juergen; Teipel, Stefan J.; Ernst, Andrea and Bergmann, Andreas, et al. (2011) In Journal of Clinical Psychiatry 72(4). p.556-563
Abstract
Objective: Development of biomarkers for early detection of Alzheimer's disease (AD) is a major clinical research goal. On the basis of the hypothesis that cardiovascular risk factors contribute to the pathogenesis of AD, we investigated whether the cardiovascular risk markers midregional proadrenomedullin (MR-proADM) and midregional proatrial natriuretic peptide (MR-proANP) predict a major clinical milestone, ie, conversion from predementia mild cognitive impairment (MCI) to manifest AD. Method: A group of 134 MCI patients, among 137 originally prospectively recruited at the memory disorder clinic at Malmo University Hospital, Malmo, Sweden, between July 1998 and June 2001, was clinically followed for 4-6 years. We determined whether... (More)
Objective: Development of biomarkers for early detection of Alzheimer's disease (AD) is a major clinical research goal. On the basis of the hypothesis that cardiovascular risk factors contribute to the pathogenesis of AD, we investigated whether the cardiovascular risk markers midregional proadrenomedullin (MR-proADM) and midregional proatrial natriuretic peptide (MR-proANP) predict a major clinical milestone, ie, conversion from predementia mild cognitive impairment (MCI) to manifest AD. Method: A group of 134 MCI patients, among 137 originally prospectively recruited at the memory disorder clinic at Malmo University Hospital, Malmo, Sweden, between July 1998 and June 2001, was clinically followed for 4-6 years. We determined whether plasma concentrations of MR-proADM and MR-proANP at baseline predicted time to conversion from MCI to clinically diagnosed AD (DSM-III-R). MCI was diagnosed according to Petersen criteria. Results: During follow-up, 41.8% of MCI patients remained cognitively stable, 42.5% converted to possible and probable AD, and 15.7% converted to other forms of dementia (MCI-other). MCI converters and MCI-other patients showed increased concentrations of MR-proANP and MR-proADM compared to the stable MCI patients (P=.0001). At a cutoff of 87 pmol/L, MR-proANP yielded a sensitivity of 73.7% and a specificity of 64.3% for predicting conversion to All. The survival analysis showed that higher values of MR-proANP and MR-proADM were associated with progression to AD. In a multivariate Cox regression model including known risk factors, MR-proANP and MR-proADM remained independent risk factors for conversion to AD for patients below the age of 72 years. Conclusions: Our study shows that plasma concentrations of MR-proANP and MR-proADM have predictive value in the progression from predementia MCI to clinical AD. Sensitivity was particularly high, which may recommend this test for first-stage screening in patients at risk for AD. J Clin Psychiatry 2011;72(4): 556-563 (C) Copyright 2010 Physicians Postgraduate Press, Inc. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Psychiatry
volume
72
issue
4
pages
556 - 563
publisher
Physicians Postgraduate Press
external identifiers
  • wos:000290012500017
  • scopus:79955519721
ISSN
0160-6689
DOI
10.4088/JCP.09m05872oli
language
English
LU publication?
yes
id
64c122b5-3a15-4cd5-9364-e47415137e8d (old id 1987758)
date added to LUP
2011-07-01 09:25:46
date last changed
2017-04-23 03:05:12
@article{64c122b5-3a15-4cd5-9364-e47415137e8d,
  abstract     = {Objective: Development of biomarkers for early detection of Alzheimer's disease (AD) is a major clinical research goal. On the basis of the hypothesis that cardiovascular risk factors contribute to the pathogenesis of AD, we investigated whether the cardiovascular risk markers midregional proadrenomedullin (MR-proADM) and midregional proatrial natriuretic peptide (MR-proANP) predict a major clinical milestone, ie, conversion from predementia mild cognitive impairment (MCI) to manifest AD. Method: A group of 134 MCI patients, among 137 originally prospectively recruited at the memory disorder clinic at Malmo University Hospital, Malmo, Sweden, between July 1998 and June 2001, was clinically followed for 4-6 years. We determined whether plasma concentrations of MR-proADM and MR-proANP at baseline predicted time to conversion from MCI to clinically diagnosed AD (DSM-III-R). MCI was diagnosed according to Petersen criteria. Results: During follow-up, 41.8% of MCI patients remained cognitively stable, 42.5% converted to possible and probable AD, and 15.7% converted to other forms of dementia (MCI-other). MCI converters and MCI-other patients showed increased concentrations of MR-proANP and MR-proADM compared to the stable MCI patients (P=.0001). At a cutoff of 87 pmol/L, MR-proANP yielded a sensitivity of 73.7% and a specificity of 64.3% for predicting conversion to All. The survival analysis showed that higher values of MR-proANP and MR-proADM were associated with progression to AD. In a multivariate Cox regression model including known risk factors, MR-proANP and MR-proADM remained independent risk factors for conversion to AD for patients below the age of 72 years. Conclusions: Our study shows that plasma concentrations of MR-proANP and MR-proADM have predictive value in the progression from predementia MCI to clinical AD. Sensitivity was particularly high, which may recommend this test for first-stage screening in patients at risk for AD. J Clin Psychiatry 2011;72(4): 556-563 (C) Copyright 2010 Physicians Postgraduate Press, Inc.},
  author       = {Buerger, Katharina and Uspenskaya, Olga and Hartmann, Oliver and Hansson, Oskar and Minthon, Lennart and Blennow, Kaj and Moeller, Hans-Juergen and Teipel, Stefan J. and Ernst, Andrea and Bergmann, Andreas and Hampel, Harald},
  issn         = {0160-6689},
  language     = {eng},
  number       = {4},
  pages        = {556--563},
  publisher    = {Physicians Postgraduate Press},
  series       = {Journal of Clinical Psychiatry},
  title        = {Prediction of Alzheimer's Disease Using Midregional Proadrenomedullin and Midregional Proatrial Natriuretic Peptide: A Retrospective Analysis of 134 Patients With Mild Cognitive Impairment},
  url          = {http://dx.doi.org/10.4088/JCP.09m05872oli},
  volume       = {72},
  year         = {2011},
}