Development and validation of a nutrition-related genetic-clinical-radiological nomogram associated with behavioral and psychological symptoms in Alzheimer’s disease

作     者：Jiang Jiwei Liu Yaou Wang Anxin Zhuo Zhizheng Shi Hanping Zhang Xiaoli Li Wenyi Sun Mengfan Jiang Shirui Wang Yanli Zou Xinying Zhang Yuan Jia Ziyan Xu Jun Jiwei Jiang;Yaou Liu;Anxin Wang;Zhizheng Zhuo;Hanping Shi;Xiaoli Zhang;Wenyi Li;Mengfan Sun;Shirui Jiang;Yanli Wang;Xinying Zou;Yuan Zhang;Ziyan Jia;Jun Xu

作者机构：Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China National Clinical Research Center for Neurological Diseases Beijing China Department of Radiology Beijing Tiantan Hospital Capital Medical University Beijing China Department of Gastrointestinal Surgery Beijing Shijitan Hospital Capital Medical University Beijing China Department of Clinical Nutrition Beijing Shijitan Hospital Capital Medical University Beijing China Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition Beijing China 

出 版 物：《中华医学杂志(英文版)》 (Chinese Medical Journal)

年 卷 期：2024年第137卷第18期

页      面：2023 Nov 29页

核心收录：

学科分类：1002[医学-临床医学] 100203[医学-老年医学] 10[医学] 

基　　金：This work was supported by grants from the National Key Research and Development Program of China(Nos. 2021YFC2500100 and 2021YFC2500103) the National Natural Science Foundation of China(Nos. 82071187 and 81870821) 

主　　题：Alzheimer’s disease Behavioral and psychological symptoms Nutrition Brain stem Cholesterol ester transfer proteins Nomogram 

摘      要：Background: Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer’s disease (AD). This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional ***: This retrospective study included 165 patients with AD from the Chinese Imaging, Biomarkers, and Lifestyle (CIBL) cohort between June 1, 2021, and March 31, 2022. Data on demographics, neuropsychological assessments, single-nucleotide polymorphisms of AD risk genes, and regional brain volumes were collected. A multivariate logistic regression model identified BPSD-associated factors, for subsequently constructing a diagnostic nomogram. This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1, 2022, and February 1, 2023. Area under receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to assess the discrimination, calibration, and clinical applicability of the ***: Factors independently associated with BPSD were:CETP rs1800775 (odds ratio [OR] = 4.137, 95% confidence interval [CI]: 1.276-13.415,P = 0.018), decreased Mini Nutritional Assessment score (OR = 0.187, 95% CI: 0.086-0.405,P 0.001), increased caregiver burden inventory score (OR = 8.993, 95% CI: 3.830-21.119,P 0.001), and decreased brain stem volume (OR = 0.006, 95% CI: 0.001-0.191,P = 0.004). These variables were incorporated into the nomogram. The area under the ROC curve was 0.925 (95% CI: 0.884-0.967,P 0.001) in the internal validation and 0.791 (95% CI: 0.686-0.895,P 0.001) in the external validation. The calibration plots showed favorable consistency between the prediction of nomogram and actual observations, and the DCA showed that the model was clinically useful in both validatio