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低出生体重与痴呆风险关联的大型前瞻性研究

Association Between Low Birth Weight and Dementia Risk: A Large-scale Prospective Study

  • 摘要:
    目的 探讨低出生体重与痴呆风险的关联及慢性疾病的中介作用,揭示基于蛋白质组学的潜在生物学通路。
    方法 基于英国生物银行(UK Biobank, UKB)279743名40~69岁研究对象数据,按出生体重分为低出生体重儿(≤2500 g)、正常出生体重儿(2500-3999 g)和巨大儿(≥4000 g),采用多变量Cox回归分析出生体重与全因痴呆及亚型(阿尔茨海默病、血管性痴呆)风险的关联,并结合蛋白质组学筛选蛋白及相关通路。
    结果 低出生体重与全因痴呆及其亚型的风险相关:全因痴呆的风险比为1.18 (95%CI 1.08, 1.30)、阿尔茨海默病为1.14 (95%CI 1.00, 1.31)、血管性痴呆为1.22(95%CI 1.01, 1.48)。出生体重与痴呆风险存在非线性关联(P非线性<0.001)。中年心血管代谢疾病(糖尿病、脑卒中、高血压、高血脂)在低出生体重和全因痴呆关联中发挥中介效应,中介比例为6.3%~15.8%。蛋白质组学鉴定出21个同时与低出生体重和痴呆关联的蛋白,富集于病毒蛋白与细胞因子及其受体的相互作用通路、脂肪因子信号通路、细胞因子-细胞因子受体相互作用通路。
    结论 低出生体重与痴呆风险呈正相关,中年心血管代谢性疾病可能介导这一关联。多种蛋白及相关通路在低出生体重和痴呆风险关联中发挥作用。

     

    Abstract:
    Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases, and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.
    Methods We used data from 279743 participants aged 40 to 69 years enrolled in the UK Biobank. Birth weight was categorized into low birth weight (≤ 2500 g), normal birth weight (2500-3999 g), and macrosomia (≥ 4000 g). Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes (Alzheimer's disease and vascular dementia). Proteomics analyses were conducted to identify proteins and the potential pathways involved.
    Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes. The hazard ratios were 1.18 (95% CI, 1.08-1.30) for all-cause dementia, 1.14 (95% CI, 1.00-1.31) for Alzheimer's disease, and 1.22 (95% CI, 1.01-1.48) for vascular dementia. A non-linear relationship was observed between birth weight and dementia risk (P for nonlinearity < 0.001). Certain cardiometabolic diseases in middle-aged adults, such as diabetes, stroke, hypertension, and dyslipidemia, played a significant mediating role in the relationship between low birth weight and dementia risk, with the mediation proportion being 6.3% to 15.8%. Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk, which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors, adipocytokine signaling, and cytokine-cytokine receptor interaction.
    Conclusion Low birth weight is positively associated with dementia risk. Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk. A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.

     

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