Key result
Elevated plasma concentrations of MR-proANP independently predicted incident all-cause dementia (HR per 1 SD 1.20; 95% CI 1.07-1.36; P=0.002) and vascular dementia.
Why the study?
Do elevated plasma levels of MR-proANP, CT-proET-1, and MR-proADM predict incident dementia in community-dwelling older adults?
Cohort (n=5,347)
Do elevated plasma levels of MR-proANP, CT-proET-1, and MR-proADM predict incident dementia in community-dwelling older adults?
MR-proANP elevation was associated with dementia risk in older adults; leaves open added value for prediction or prevention trials.
Background Cerebral endothelial dysfunction occurs in a spectrum of neurodegenerative diseases. Whether biomarkers of microvascular endothelial dysfunction can predict dementia is largely unknown. We explored the longitudinal association of midregional pro‐atrial natriuretic peptide (MR‐proANP), C‐terminal endothelin‐1 (CT‐proET‐1) and midregional proadrenomedullin (MR‐proADM) with dementia and subtypes amongst community‐dwelling older adults. Methods A population‐based cohort of 5347 individuals (men, 70%; age, 69 ± 6 years) without prevalent dementia provided plasma for determination of MR‐proANP, CT‐proET‐1 and MR‐proADM. Three‐hundred‐and‐seventy‐three patients (7%) were diagnosed with dementia (120 Alzheimer's disease, 83 vascular, 102 mixed, and 68 other aetiology) over a period of 4.6 ± 1.3 years. Relations between baseline biomarker plasma concentrations and incident dementia were assessed using multivariable Cox regression analysis. Results Higher levels of MR‐proANP were significantly associated with increased risk of all‐cause and vascular dementia (hazard ratio [HR] per 1 SD: 1.20, 95% confidence interval [CI], 1.07–1.36; P = 0.002, and 1.52; 1.21–1.89; P < 0.001, respectively). Risk of all‐cause dementia increased across the quartiles of MR‐proANP (p for linear trend = 0.004; Q4, 145–1681 pmol L −1 vs. Q1, 22–77 pmol L −1 : HR: 1.83; 95%CI: 1.23–2.71) and was most pronounced for vascular type (p for linear trend = 0.005: HR: 2.71; 95%CI: 1.14–6.46). Moreover, the two highest quartiles of CT‐proET‐1 predicted vascular dementia with a cut‐off value at 68 pmol L −1 (Q3–Q4, 68–432 pmol L −1 vs. Q1–Q2,4–68 pmol L −1 ; HR: 1.94; 95%CI: 1.12–3.36). Elevated levels of MR‐proADM indicated no increased risk of developing dementia after adjustment for traditional risk factors. Conclusions Elevated plasma concentration of MR‐proANP is an independent predictor of all‐cause and vascular dementia. Pronounced increase in CT‐proET‐1 indicates higher risk of vascular dementia.
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Holm et al. (2017) conducted a cohort in Incident dementia (n=5,347). Midregional pro-atrial natriuretic peptide (MR-proANP) vs. Lower levels of MR-proANP was evaluated on Incident all-cause dementia (HR 1.20, 95% CI 1.07-1.36, p=0.002). Elevated plasma concentrations of MR-proANP independently predicted incident all-cause dementia (HR per 1 SD 1.20; 95% CI 1.07-1.36; P=0.002) and vascular dementia.
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