Hafif-Orta Evre Alzheimer Hastalığında MPV’nin Serebral Vasküler İskemik Yükle İlişkisi

Year 2023, , 597 - 602, 28.09.2023

Esra Erkoç Ataoğlu , Murat Uçar

https://doi.org/10.53424/balikesirsbd.1291438

Abstract

Amaç: Alzheimer Hastalığı’nın (AH) temelinde, vasküler patolojiler ve kronik nöroinflamasyon önemli yer tutmaktadır. Ateroskleroz ve sistemik inflamasyon patofizyolojisinde kritik rol oynayan trombosit aktivitesinin de, AH’de arttığı çok kez bildirilmiştir. Ancak bu artışın, hastalıktaki nörogörüntüleme korelatlarıyla ilişkisi henüz incelenmemiştir. Bu çalışmada amaç, trombosit aktivitesinin göstergesi olan ortalama trombosit hacminin (MPV), AH nörogörüntülemesindeki vasküler iskemik yükle ilişkisini değerlendirmektir. Gereç ve Yöntem: 2021-2022 yılları arasında demans polikliniğimizde tanı alan hafif-orta evre AH olgularının kayıtları retrospektif incelendi. Hastalar MRG’deki iskemik yüke göre “ağır” veya “hafif” olarak sınıflandırıldı ve klinik bulgular ile platelet belirteçleri (Platelet-PLT, Platelet Dağılım Genişliği-PDW, Ortalama Trombosit Hacmi-MPV) gruplar arasında karşılaştırıldı. Vasküler yükle ilişkili potansiyel değişkenlere yönelik çoklu regresyon analizi uygulandı. Bulgular: İncelenen 59 hastanın 36’sı MRG’de ‘hafif’, 23’ü ‘ağır’ vasküler iskemik yüke sahipti. Gruplar demografik ve klinik yönden benzerken; MPV ağır iskemik yükü olan grupta anlamlı yüksekti (p:0.013). Çoklu regresyonda, MPV ve iskemik yük arasında bağımsız ilişki gözlendi. ≥8.7 fL MPV değerinin ağır serebral iskemik yük varlığı açısından %69,6 duyarlılığa ve %61 özgüllüğe sahip olduğu görüldü. Sonuç: Bulgularımız AH vasküler patogenezinde trombosit aktivasyonunun rolünü vurgulamaktadır. Artmış MPV AH’nın erken dönem değerlendirmesinde, serebral iskemik yük açısından yüksek riskli grubun belirlenmesinde bir belirteç olarak kullanılabilir. Bu erken tespit; vasküler morbiditeler açısından yakın takibe ve korunma/tedavi stratejilerini zamanında planlamaya olanak sağlayacaktır.

Keywords

Anahtar Kelimeler: Alzheimer Hastalığı, ortalama trombosit hacmi, MPV, vasküler iskemik yük, inflamasyon

Supporting Institution

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Project Number

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Thanks

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Association between MPV and Cerebral Vascular Ischemic Burden in Mild to Moderate Alzheimers’s Disease

Abstract

Objective: Vascular pathologies and chronic neuroinflammation play an important role in Alzheimer's Disease (AD). Increased platelet activity, which underlies the pathophysiology of atherosclerosis and systemic inflammation, has been reported several times of AD. However, the relationship between this increase and neuroimaging correlates has not been studied yet. This study aims to evaluate the relationship between mean platelet volume (MPV), as a reliable indicator of platelet activity, and vascular ischemic burden in neuroimaging of AD. Materials and Methods: Medical records of mild-moderate AD cases diagnosed in our dementia outpatient clinic between 2021-2022 were retrospectively reviewed. Patients were classified as having "mild" or "severe" vascular ischemic burden on MRI. Clinical findings and platelet markers (Platelet-PLT, Platelet Distribution Width-PDW, Mean Platelet Volume-MPV) were compared between the groups. Multivariate regression was applied for potential confounders regarding vascular ischemic burden. Results: Out of 59 patients, 36 had ‘mild' and 23 had 'severe' ischemic burden. Demographic and clinical features were similar; however, MPV was significantly higher in the group with severe ischemia (p:0.013). Multivariate analysis revealed an independent association between MPV and ischemic burden. An MPV value of ≥8.7 fL had a sensitivity of 69.6% and a specificity of 61% for severe burden. Conclusion: Our results highlight the role of platelet activation in the vascular pathogenesis of AD. During the early evaluation of AD, increased MPV can serve as a marker to determine the high-risk group in terms of cerebral ischemic burden. This might enable close monitoring and timely management of high-risk patients regarding the development of vascular morbidities.

Keywords

Alzheimer, mean platelet volume, MPV, vascular ischemic burden, inflammation

Project Number

Yok

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