Background:The neuropeptide neurotensin (NT) has been linked to cardiometabolic disease. Cardiovascular risk factors are being recognized as risk factors for cognitive impairment. Objective:To examine the association of the stable precursor of NT, pro-neurotensin/neuromedin N (pro-NT/NMN), with incident cognitive impairment (ICI). Methods:We conducted a prospective nested case-control study in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. In 2003-2007, REGARDS enrolled 30,239 Black and White adults aged ≥45. ICI was identified using a 3-test cognitive battery administered biannually. Baseline pro-NT/NMN was measured by immunoassay in 393 cases of ICI and 490 controls after 3.4 years follow up. Multivariable logistic regression was used to calculate odds ratios (OR) of ICI by pro-NT/NMN quartiles. Race, age, and sex differences were studied with stratified models and interaction testing. Results:Pro-NT/NMN was higher in Blacks and those with hypertension and diabetes. Women with a 4th versus 1st-quartile pro-NT/NMN had 2.28-fold increased odds of ICI (95% CI 1.08–4.78) after adjusting for risk factors and incident stroke. There was no association of higher pro-NT/NMN quartiles with ICI in the overall group or men. There were no race or age differences in associations. Conclusion:In this biracial population-based study, elevated systemic pro-NT/NMN was associated with more than doubled risk of ICI in women but not men. Others reported sex-specific associations in women for cardiovascular mortality and diabetes with higher pro-NT/NMN, supporting a role for future research on sex differences in the neurotensinergic system.

中文翻译：

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一项前瞻性研究中的前神经降压素/神经调节素N与认知障碍的风险。

背景：神经肽神经降压素（NT）与心脏代谢疾病有关。心血管危险因素被认为是认知障碍的危险因素。目的：探讨NT的稳定前体，神经降压素/ neuromedin N（pro-NT / NMN）与事件性认知障碍（ICI）的关系。方法：我们在卒中地理和种族差异的原因（REGARDS）队列中进行了前瞻性的嵌套病例对照研究。在2003-2007年，REGARDS招募了30239名年龄在45岁以上的黑人和白人。IIC使用每半年一次的3次测试认知电池进行鉴定。在3.4年的随访中，通过免疫测定法对393例ICI患者和490例对照患者进行了基线pro-NT / NMN测定。多变量对数回归用于通过pro-NT / NMN四分位数计算ICI的优势比（OR）。种族，年龄，通过分层模型和互动测试研究了性别差异。结果：Pro-NT / NMN在黑人以及患有高血压和糖尿病的人群中较高。调整危险因素和中风后，前NT / NMN前四分之一与四分之一女性的ICI几率增加了2.28倍（95％CI 1.08–4.78）。在整个组或男性中，较高的前NT / NMN四分位数与ICI没有关联。协会中没有种族或年龄差异。结论：在这项基于种族混血儿的研究中，全身性pro-NT / NMN升高与女性而非男性的ICI风险增加了一倍以上有关。其他人报告说，妇女的心血管死亡率和糖尿病与性别特异性相关，前NT / NMN值较高，这支持了未来在神经降压系统中性别差异研究中的作用。