dr. harman

Yamamoto H, Watanabe T, Miyazaki A, Katagiri T, Idei T, Iguchi T,
Mimura M, Kamijima K.

Department of Neuropsychiatry, Showa University School of Medicine,
1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan.

OBJECTIVES: To determine the relationships between Chlamydia pneumoniae
infection, carotid atherosclerosis, and dyslipidemia in patients with
vascular dementia (VaD) and Alzheimer's disease (AD). DESIGN: Case
control study. SETTING: Showa University Karasuyama Hospital, Tokyo,
Japan. PARTICIPANTS: One hundred twenty-four elderly subjects: 31 with
VaD, 61 with AD, and 32 age-matched controls without dementia.
MEASUREMENTS: Presence of antibodies to C. pneumoniae (immunoglobulin G
(IgG) and IgA), the serum concentrations of high-sensitive C-reactive
protein (hs-CRP) and atherogenic lipoproteins, and the carotid artery
intima-media thickness (IMT) and plaques were determined. RESULTS: Age;
body mass index; systolic and diastolic blood pressures; and fasting
plasma glucose, hemoglobin A(1c), high-density lipoprotein cholesterol,
and apolipoprotein A-I, B, and E concentrations did not differ
significantly between the three groups, but the mean IMT and frequency
of atherosclerotic plaques in the carotid arteries, as well as the
serum concentrations of low-density lipoprotein cholesterol (LDL-C),
lipoprotein(a), and lipid peroxides were significantly greater in VaD
patients than in AD patients or nondemented controls. Hs-CRP
concentrations and prevalence of C. pneumoniae IgG and IgA antibodies
also were significantly higher in VaD patients than in AD patients and
nondemented controls. Multiple logistic regression ****ysis revealed
that carotid IMT and plaques, LDL-C, lipid peroxides, hs-CRP, and IgG
and IgA C. pneumoniae seropositivity were independent risk factors for
VaD. CONCLUSION: These results suggest that carotid atherosclerosis,
atherogenic lipoproteins, and C. pneumoniae infection (as do***ented by
the IgG and IgA seropositivity together with increased hs-CRP) may be
VaD risk factors.