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Confounding factors of Alzheimer's disease plasma biomarkers and their impact on clinical performance

Pichet Binette, Alexa LU ; Janelidze, Shorena LU ; Cullen, Nicholas LU ; Dage, Jeffrey L. ; Bateman, Randall J. ; Zetterberg, Henrik LU ; Blennow, Kaj LU ; Stomrud, Erik LU orcid ; Mattsson-Carlgren, Niklas LU orcid and Hansson, Oskar LU orcid (2023) In Alzheimer's and Dementia 19(4). p.1403-1414
Abstract

Introduction: Plasma biomarkers will likely revolutionize the diagnostic work-up of Alzheimer's disease (AD) globally. Before widespread use, we need to determine if confounding factors affect the levels of these biomarkers, and their clinical utility. Methods: Participants with plasma and CSF biomarkers, creatinine, body mass index (BMI), and medical history data were included (BioFINDER-1: n = 748, BioFINDER-2: n = 421). We measured beta-amyloid (Aβ42, Aβ40), phosphorylated tau (p-tau217, p-tau181), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). Results: In both cohorts, creatinine and BMI were the main factors associated with NfL, GFAP, and to a lesser extent with p-tau. However, adjustment for BMI and... (More)

Introduction: Plasma biomarkers will likely revolutionize the diagnostic work-up of Alzheimer's disease (AD) globally. Before widespread use, we need to determine if confounding factors affect the levels of these biomarkers, and their clinical utility. Methods: Participants with plasma and CSF biomarkers, creatinine, body mass index (BMI), and medical history data were included (BioFINDER-1: n = 748, BioFINDER-2: n = 421). We measured beta-amyloid (Aβ42, Aβ40), phosphorylated tau (p-tau217, p-tau181), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). Results: In both cohorts, creatinine and BMI were the main factors associated with NfL, GFAP, and to a lesser extent with p-tau. However, adjustment for BMI and creatinine had only minor effects in models predicting either the corresponding levels in CSF or subsequent development of dementia. Discussion: Creatinine and BMI are related to certain plasma biomarkers levels, but they do not have clinically relevant confounding effects for the vast majority of individuals. Highlights: Creatinine and body mass index (BMI) are related to certain plasma biomarker levels. Adjusting for creatinine and BMI has minor influence on plasma-cerebrospinal fluid (CSF) associations. Adjusting for creatinine and BMI has minor influence on prediction of dementia using plasma biomarkers.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
amyloid, cerebrospinal fluid, dementia, glial fibrillary acidic protein, neurofilament light, p-tau
in
Alzheimer's and Dementia
volume
19
issue
4
pages
1403 - 1414
publisher
Wiley
external identifiers
  • pmid:36152307
  • scopus:85138752020
ISSN
1552-5260
DOI
10.1002/alz.12787
language
English
LU publication?
yes
id
ae63d221-eca9-462e-8632-2ca02ffe494f
date added to LUP
2022-12-19 15:09:28
date last changed
2024-04-18 17:25:56
@article{ae63d221-eca9-462e-8632-2ca02ffe494f,
  abstract     = {{<p>Introduction: Plasma biomarkers will likely revolutionize the diagnostic work-up of Alzheimer's disease (AD) globally. Before widespread use, we need to determine if confounding factors affect the levels of these biomarkers, and their clinical utility. Methods: Participants with plasma and CSF biomarkers, creatinine, body mass index (BMI), and medical history data were included (BioFINDER-1: n = 748, BioFINDER-2: n = 421). We measured beta-amyloid (Aβ42, Aβ40), phosphorylated tau (p-tau217, p-tau181), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). Results: In both cohorts, creatinine and BMI were the main factors associated with NfL, GFAP, and to a lesser extent with p-tau. However, adjustment for BMI and creatinine had only minor effects in models predicting either the corresponding levels in CSF or subsequent development of dementia. Discussion: Creatinine and BMI are related to certain plasma biomarkers levels, but they do not have clinically relevant confounding effects for the vast majority of individuals. Highlights: Creatinine and body mass index (BMI) are related to certain plasma biomarker levels. Adjusting for creatinine and BMI has minor influence on plasma-cerebrospinal fluid (CSF) associations. Adjusting for creatinine and BMI has minor influence on prediction of dementia using plasma biomarkers.</p>}},
  author       = {{Pichet Binette, Alexa and Janelidze, Shorena and Cullen, Nicholas and Dage, Jeffrey L. and Bateman, Randall J. and Zetterberg, Henrik and Blennow, Kaj and Stomrud, Erik and Mattsson-Carlgren, Niklas and Hansson, Oskar}},
  issn         = {{1552-5260}},
  keywords     = {{amyloid; cerebrospinal fluid; dementia; glial fibrillary acidic protein; neurofilament light; p-tau}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1403--1414}},
  publisher    = {{Wiley}},
  series       = {{Alzheimer's and Dementia}},
  title        = {{Confounding factors of Alzheimer's disease plasma biomarkers and their impact on clinical performance}},
  url          = {{http://dx.doi.org/10.1002/alz.12787}},
  doi          = {{10.1002/alz.12787}},
  volume       = {{19}},
  year         = {{2023}},
}