Molly Fox, Carlo Berzuini, Leslie A Knapp, Laura M Glynn
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引用次数: 36
摘要
背景:妊娠与持续进入老年期的免疫调节改善有关。免疫调节受损与阿尔茨海默病(AD)的发病机制有关。因此,我们研究妊娠与AD的关系。方法:英国女性横断面队列(N = 95)。Cox比例风险模型评估了累积怀孕月份对AD风险的假定影响,以及妊娠早期和晚期计数对AD风险的相互调整影响。结果:累积怀孕月数与AD风险降低相关(β = -1.90, exp(β) = 0.15, P = 0.02)。在调整晚期妊娠后,累积妊娠数与较低的AD风险相关(β = -3.83, exp(β) = 0.02, P < 0.01),而在调整晚期妊娠后,晚期妊娠无显著影响。结论:根据我们的观察,妊娠早期(但不是妊娠晚期)对AD的保护作用与免疫作用更一致,免疫作用是由妊娠早期驱动的,而雌激素暴露在妊娠后期最大。结果可能证明未来免疫生物标志物的研究是正确的。
Women's Pregnancy Life History and Alzheimer's Risk: Can Immunoregulation Explain the Link?
Background: Pregnancy is associated with improvement in immunoregulation that persists into the geriatric phase. Impaired immunoregulation is implicated in Alzheimer's disease (AD) pathogenesis. Hence, we investigate the relationship between pregnancy and AD.
Methods: Cross-sectional cohort of British women (N = 95). Cox proportional hazards modeling assessed the putative effects of cumulative months pregnant on AD risk and the mutually adjusted effects of counts of first and third trimesters on AD risk.
Results: Cumulative number of months pregnant, was associated with lower AD risk (β = -1.90, exp(β) = 0.15, P = .02). Cumulative number of first trimesters was associated with lower AD risk after adjusting for third trimesters (β = -3.83, exp(β) = 0.02, P < .01), while the latter predictor had no significant effect after adjusting for the former.
Conclusions: Our observation that first trimesters (but not third trimesters) conferred protection against AD is more consistent with immunologic effects, which are driven by early gestation, than estrogenic exposures, which are greatest in late gestation. Results may justify future studies with immune biomarkers.
期刊介绍:
American Journal of Alzheimer''s Disease and other Dementias® (AJADD) is for professionals on the frontlines of Alzheimer''s care, dementia, and clinical depression--especially physicians, nurses, psychiatrists, administrators, and other healthcare specialists who manage patients with dementias and their families. This journal is a member of the Committee on Publication Ethics (COPE).