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Endothelium-related biomarkers and cognitive decline in prevalent hemodialysis patients: A prospective cohort study.
Libório, Alexandre Braga; de Medeiros, Camila Maroni Marques Freire; Santos, Leticia Libório; de Andrade, Luana Silveira; Meneses, Gdayllon Cavalcante; Martins, Alice Maria Costa.
Afiliação
  • Libório AB; Medical Sciences Postgraduate Program, Universidade de Fortaleza-UNIFOR, Fortaleza, Ceará, Brazil.
  • de Medeiros CMMF; Department of Internal Medicine, Medical School, Federal University of Ceará, Fortaleza, Ceará, Brazil.
  • Santos LL; Medical Program, Universidade de Fortaleza-UNIFOR, Fortaleza, Ceará, Brazil.
  • de Andrade LS; Medical Program, Universidade de Fortaleza-UNIFOR, Fortaleza, Ceará, Brazil.
  • Meneses GC; Medical Sciences Postgraduate Program, Department of Internal Medicine, Medical School, Federal University of Ceará, Fortaleza, Ceará, Brazil.
  • Martins AMC; Clinical and Toxicological Analysis Department, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Eur J Neurol ; : e16438, 2024 Aug 13.
Article em En | MEDLINE | ID: mdl-39136139
ABSTRACT

INTRODUCTION:

Cognitive decline is prevalent in maintenance hemodialysis patients. The blood-brain barrier has been implicated in cognitive decline. In this prospective cohort study, we investigated the associations between endothelium-related biomarkers and steeper cognitive decline in this population.

METHODS:

Cognitive function was assessed using the Portuguese-adapted Cambridge Cognitive Examination (CAMCOG) with items of the Mini-Mental State Examination (MMSE). Endothelium-related biomarkers included syndecan-1, ICAM-1, VCAM-1 and angiopoietin-2 (AGPT2). Patients were followed up for 4 years, and cognitive assessments were repeated. Multinomial regression analyses were performed to evaluate associations between biomarkers and cognitive decline.

RESULTS:

A total of 216 patients completed the test battery at baseline. After 4 years, 102 patients had follow-up data. There was a significant decrease in cognitive function according to the CAMCOG and MMSE scores a change of -0.39 (95% CI -0.27 to -0.51) and -0.51 (95% CI -0.27 to -0.76) standard deviation (SD) of the baseline scores. Additionally, executive function but not memory significantly decreased. Syndecan-1 level was independently associated with steeper cognitive decline; each increase in the SD of the syndecan-1 level was associated with a decrease in the CAMCOG of 0.20 (95% CI 0.07-0.33) SD from baseline. Syndecan-1 was associated with a steeper decline in MMSE score (ß 0.54, 95% CI 0.28-0.81) and executive function (ß 0.17, 95% CI 0.02-0.32). Syndecan-1 predicted severe cognitive impairment with an area under the curve for receiver operating characteristic curves of 0.75 (95% CI 0.64-0.83).

CONCLUSION:

Our findings highlight the potential of syndecan-1, a biomarker of endothelium glycocalyx derangement, as a predictor of steeper cognitive decline in prevalent hemodialysis patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Eur J Neurol Assunto da revista: NEUROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Eur J Neurol Assunto da revista: NEUROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido