Serum neurofilament light chain as a prognostic marker of all-cause mortality in a national sample of US adults.

Autor: Beydoun MA; Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA. baydounm@mail.nih.gov.; NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview Blvd., Suite 100, Room #: 04B118, Baltimore, MD, 21224, USA. baydounm@mail.nih.gov., Noren Hooten N; Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA., Georgescu MF; Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA., Beydoun HA; Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA., Eid SM; Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA., Fanelli-Kuczmarski MT; Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA., Evans MK; Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA., Zonderman AB; Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: European journal of epidemiology [Eur J Epidemiol] 2024 Jul; Vol. 39 (7), pp. 795-809. Date of Electronic Publication: 2024 May 21.
DOI: 10.1007/s10654-024-01131-7
Abstrakt: Neurofilament light chain (NfL) is a neuron-specific structural protein released into the extracellular space, including body fluids, upon neuroaxonal damage. Despite evidence of a link in neurological disorders, few studies have examined the association of serum NfL with mortality in population-based studies. Data from the National Health and Nutrition Survey were utilized including 2,071 Non-Hispanic White, Non-Hispanic Black and Hispanic adult participants and adult participants of other ethnic groups (20-85 years) with serum NfL measurements who were followed for ≤ 6 years till 2019. We tested the association of serum NfL with mortality in the overall population and stratified by sex with the addition of potential interactive and mediating effects of cardio-metabolic risk factors and nutritional biomarkers. Elevated serum NfL levels (above median group) were associated with mortality risk compared to the below median NfL group in the overall sample (P = 0.010), with trends observed within each sex group (P < 0.10). When examining Log e NfL as a continuum, one standard deviation of Log e NfL was associated with an increased mortality risk (HR = 1.88, 95% CI 1.60-2.20, P < 0.001) in the reduced model adjusted for age, sex, race, and poverty income ratio; a finding only slightly attenuated with the adjustment of lifestyle and health-related factors. Four-way decomposition indicated that there was, among others, mediated interaction between NfL and HbA1c and a pure inconsistent mediation with 25(OH)D3 in predicting all-cause mortality, in models adjusted for all other covariates. Furthermore, urinary albumin-to-creatinine ratio interacted synergistically with NfL in relation to mortality risk both on the additive and multiplicative scales. These data indicate that elevated serum NfL levels were associated with all-cause mortality in a nationally representative sample of US adults.
(© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
Databáze: MEDLINE
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