Positive rate and quantification of amyloid pathology with [18F]florbetapir in the urban Chinese population

Kun He; Binyin Li; Lin Huang; Jun Zhao; Fengchun Hua; Tao Wang; Junpeng Li; Jie Wang; Qi Huang; Keliang Chen; Shasha Xu; Shuhua Ren; Huawei Cai; Donglang Jiang; Jingchao Hu; Xingmin Han; Yihui Guan; Kewei Chen; Qihao Guo; Fang Xie

doi:10.1007/s00330-023-10366-z

Positive rate and quantification of amyloid pathology with [¹⁸F]florbetapir in the urban Chinese population

Eur Radiol. 2023 Oct 27. doi: 10.1007/s00330-023-10366-z. Online ahead of print.

Authors

Kun He^#¹, Binyin Li^#², Lin Huang^#³, Jun Zhao⁴, Fengchun Hua⁵, Tao Wang⁶, Junpeng Li¹, Jie Wang¹, Qi Huang¹, Keliang Chen⁷, Shasha Xu⁸, Shuhua Ren¹, Huawei Cai⁹, Donglang Jiang¹, Jingchao Hu^{3

10}, Xingmin Han⁸, Yihui Guan¹, Kewei Chen¹¹, Qihao Guo¹², Fang Xie¹³

Affiliations

¹ Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, 200040, China.
² Department of Neurology and Institute of Neurology, School of Medicine Affiliated Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, 200020, China.
³ Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
⁴ Department of Nuclear Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200120, China.
⁵ Department of Nuclear Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
⁶ Department of Geriatric Psychiatry, Shanghai Mental Health Centre, Shanghai Jiaotong University School of Medicine, Shanghai, 200122, China.
⁷ Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
⁸ Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
⁹ Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
¹⁰ School of Nursing, Shanghai Jiaotong University, Shanghai, 200025, China.
¹¹ Banner Alzheimer Institute, Arizona State University, University of Arizona and Arizona Alzheimer's Consortium, Phoenix, AZ, USA.
¹² Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China. qhguo@sjtu.edu.cn.
¹³ Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, 200040, China. fangxie@fudan.edu.cn.

^# Contributed equally.

PMID: 37889270
DOI: 10.1007/s00330-023-10366-z

Abstract

Objectives: Amyloid deposition is considered the initial pathology in Alzheimer's disease (AD). Personalized management requires investigation of amyloid pathology and the risk factors for both amyloid pathology and cognitive decline in the Chinese population. We aimed to investigate amyloid positivity and deposition in AD patients, as well as factors related to amyloid pathology in Chinese cities.

Methods: This cross-sectional multicenter study was conducted in Shanghai and Zhengzhou, China. All participants were recruited from urban communities and memory clinics. Amyloid positivity and deposition were analyzed based on amyloid positron emission tomography (PET). We used partial least squares (PLS) models to investigate how related factors contributed to amyloid deposition and cognitive decline.

Results: In total, 1026 participants were included: 768 participants from the community-based cohort (COMC) and 258 participants from the clinic-based cohort (CLIC). The overall amyloid-positive rates in individuals with clinically diagnosed AD, mild cognitive impairment (MCI), and normal cognition (NC) were 85.8%, 44.5%, and 26.9%, respectively. The global amyloid deposition standardized uptake value ratios (SUVr) (reference: cerebellar crus) were 1.44 ± 0.24, 1.30 ± 0.22, and 1.24 ± 0.14, respectively. CLIC status, apolipoprotein E (ApoE) ε4, and older age were strongly associated with amyloid pathology by PLS modeling.

Conclusion: The overall amyloid-positive rates accompanying AD, MCI, and NC in the Chinese population were similar to those in published cohorts of other populations. ApoE ε4 and CLIC status were risk factors for amyloid pathology across the AD continuum. Education was a risk factor for amyloid pathology in MCI. Female sex and age were risk factors for amyloid pathology in NC.

Clinical relevance statement: This study provides new details about amyloid pathology in the Chinese population. Factors related to amyloid deposition and cognitive decline can help to assess patients' AD risk.

Key points: • We studied amyloid pathology and related risk factors in the Chinese population. •·The overall amyloid-positive rates in individuals with clinically diagnosed AD, MCI, and NC were 85.8%, 44.5%, and 26.9%, respectively. • These overall amyloid-positive rates were in close agreement with the corresponding prevalence for other populations.

Keywords: Alzheimer’s disease; Amyloid deposits; ApoE; Community.

Abstract

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