Genetics
A CETP variant is one of four factors in a nomogram predicting behavioral symptoms in Alzheimer's disease (Chin Med J 2024)
Original title: Development and validation of a nutrition-related genetic-clinical-radiological nomogram associated with behavioral and psychological symptoms in Alzheimer's disease
In a retrospective study of 165 Alzheimer's disease patients from the Chinese Imaging, Biomarkers, and Lifestyle cohort, researchers built and validated a nomogram to predict behavioral and psychological symptoms of dementia (BPSD) from genetic, clinical and radiological factors. Multivariate logistic regression identified four independently associated factors: the CETP variant rs1800775 (odds ratio 4.137, 95% CI 1.276 to 13.415, P equals 0.018), a lower Mini Nutritional Assessment score, a higher caregiver burden inventory score, and lower brain stem volume. The resulting nomogram, incorporating these lipid-metabolism-related genetic, nutritional and neuroimaging factors, achieved an area under the ROC curve of 0.925 internally and 0.791 externally, supporting its clinical usefulness for early triage of BPSD risk in Alzheimer's disease.
Original abstract
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 mechanism.
Methods: 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 nomogram.
Results: 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 validations.
Conclusion: A novel nomogram was established and validated based on lipid metabolism-related genes, nutritional status, and brain stem volumes, which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD.
Registration: Chictr.org.cn , ChiCTR2100049131.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.