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Koetsier J, Cavill R, Reijnders R, Harvey J, Homann J, Kouhsar M, Deckers K, Köhler S, Eijssen LMT, van den Hove DLA, Demuth I, Düzel S, Smith RG, Smith AR, Burrage J, Walker EM, Shireby G, Hannon E, Dempster E, Frayling T, Mill J, Dobricic V, Johannsen P, Wittig M, Franke A, Vandenberghe R, Schaeverbeke J, Freund-Levi Y, Frölich L, Scheltens P, Teunissen CE, Frisoni G, Blin O, Richardson JC, Bordet R, Engelborghs S, de Roeck E, Martinez-Lage P, Tainta M, Lleó A, Sala I, Popp J, Peyratout G, Verhey F, Tsolaki M, Andreasson U, Blennow K, Zetterberg H, Streffer J, Vos SJB, Lovestone S, Visser PJ, Lill CM, Bertram L, Lunnon K, Pishva E. Blood-based multivariate methylation risk score for cognitive impairment and dementia. Alzheimers Dement 2024. [PMID: 39193899 DOI: 10.1002/alz.14061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 08/29/2024]
Abstract
INTRODUCTION The established link between DNA methylation and pathophysiology of dementia, along with its potential role as a molecular mediator of lifestyle and environmental influences, positions blood-derived DNA methylation as a promising tool for early dementia risk detection. METHODS In conjunction with an extensive array of machine learning techniques, we employed whole blood genome-wide DNA methylation data as a surrogate for 14 modifiable and non-modifiable factors in the assessment of dementia risk in independent dementia cohorts. RESULTS We established a multivariate methylation risk score (MMRS) for identifying mild cognitive impairment cross-sectionally, independent of age and sex (P = 2.0 × 10-3). This score significantly predicted the prospective development of cognitive impairments in independent studies of Alzheimer's disease (hazard ratio for Rey's Auditory Verbal Learning Test (RAVLT)-Learning = 2.47) and Parkinson's disease (hazard ratio for MCI/dementia = 2.59). DISCUSSION Our work shows the potential of employing blood-derived DNA methylation data in the assessment of dementia risk. HIGHLIGHTS We used whole blood DNA methylation as a surrogate for 14 dementia risk factors. Created a multivariate methylation risk score for predicting cognitive impairment. Emphasized the role of machine learning and omics data in predicting dementia. The score predicts cognitive impairment development at the population level.
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Affiliation(s)
- Jarno Koetsier
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Rachel Cavill
- Department of Advanced Computing Sciences (DACS), Faculty of Science and Engineering (FSE), Maastricht University, Maastricht, The Netherlands
| | - Rick Reijnders
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Joshua Harvey
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Jan Homann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Morteza Kouhsar
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Kay Deckers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Lars M T Eijssen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
- Department of Bioinformatics - BiGCaT, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Daniel L A van den Hove
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Dr. Manuel Nagel, Würzburg, Germany
| | - Ilja Demuth
- Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- BCRT - Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sandra Düzel
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Rebecca G Smith
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Adam R Smith
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Joe Burrage
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Emma M Walker
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Gemma Shireby
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Eilis Hannon
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Emma Dempster
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Tim Frayling
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Jonathan Mill
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Valerija Dobricic
- Lübeck Interdisciplinary Platform for Genome Analytics (LIGA), University of Lübeck, Lübeck, Germany
| | - Peter Johannsen
- Danish Dementia Research Centre, Rigshospitalet, Copenhagen, Denmark
| | - Michael Wittig
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | | | - Yvonne Freund-Levi
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Geriatrics, Södertälje Hospital, Södertälje, Sweden
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health; Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Laboratory Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Giovanni Frisoni
- Memory Center, Geneva University and University Hospitals; on behalf of the AMYPAD Consortium, Genève, Switzerland
| | - Olivier Blin
- Aix-Marseille University-CNRS, Marseille, France
| | - Jill C Richardson
- Neuroscience Therapeutic Area, GlaxoSmithKline R&D, Stevenage, Hertfordshire, UK
| | | | - Sebastiaan Engelborghs
- Department of Biomedical Sciences, University of Antwerp, Antwerpen, Belgium
- Neuroprotection & Neuromodulation (NEUR) Research Group, Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Jette, Brussels, Belgium
| | - Ellen de Roeck
- Department of Biomedical Sciences, University of Antwerp, Antwerpen, Belgium
| | - Pablo Martinez-Lage
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Gipuzkoa, Spain
| | - Mikel Tainta
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Gipuzkoa, Spain
| | - Alberto Lleó
- Neurology Department, Centro de Investigación en Red en enfermedades neurodegenerativas (CIBERNED), Hospital Sant Pau, Sant Antoni Maria Claret, Barcelona, Spain
| | - Isabel Sala
- Neurology Department, Centro de Investigación en Red en enfermedades neurodegenerativas (CIBERNED), Hospital Sant Pau, Sant Antoni Maria Claret, Barcelona, Spain
| | - Julius Popp
- University Hospital of Psychiatry Zürich, University of Zürich, Zürich, Switzerland
| | - Gwendoline Peyratout
- Department of Psychiatry, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Magda Tsolaki
- 1st Department of Neurology, School of Medicine, `Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki, and Alzheimer Hellas, Macedonia, Balkan Center, Thessaloniki, Greece
| | - Ulf Andreasson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
- Clinical Neurochemistry Lab, Sahlgrenska University Hospital, Göteborg, Sweden
- Paris Brain Institute, ICM, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, and Department of Neurology, Institute on Aging and Brain Disorders, University of Science and Technology of China and First Affiliated Hospital of USTC, Hefei, P.R. China
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, Maple House, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Shatin, N.T., Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Johannes Streffer
- AC Immune SA, formerly Janssen R&D, LLC. Beerse, Belgium at the time of study conduct, Lausanne, Switzerland
| | - Stephanie J B Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Simon Lovestone
- University of Oxford, Oxford, United Kingdom; Currently at Johnson & Johnson Innovative Medicines, Beerse, Belgium
| | - Pieter-Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
- Department of Geriatrics, Södertälje Hospital, Södertälje, Sweden
| | - Christina M Lill
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College, South Kensington Campus, London, UK
| | - Lars Bertram
- Lübeck Interdisciplinary Platform for Genome Analytics (LIGA), University of Lübeck, Lübeck, Germany
| | - Katie Lunnon
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Ehsan Pishva
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
- Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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Goda A, Nakano H, Kikuchi Y, Mori K, Mitsumaru N, Murata S. Association between Subjective Cognitive Complaints and Sleep Disturbance among Community-Dwelling Elderly Individuals in Japan. Healthcare (Basel) 2024; 12:1245. [PMID: 38998780 PMCID: PMC11241042 DOI: 10.3390/healthcare12131245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/23/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
Subjective cognitive complaints (SCCs) are a crucial modifiable risk factor for dementia. There is increasing interest in the association between SCC and sleep disturbance; however, the effects of sleep disturbance on SCC development among community-dwelling elderly individuals in Japan remain unclear. We aimed to cross-sectionally investigate the association between SCC and sleep disturbance, with adjustment for multiple factors related to cognitive decline, among 241 community-dwelling elderly persons without cognitive impairment. The measures were SCCs (Kihon Checklist-Cognitive Function, KCL-CF), sleep disturbance (Japanese version of the Athens Insomnia Scale, AIS-J), general cognitive function (Mini-Mental State Examination), and depressive symptoms (five-item version of the Geriatric Depression Scale [GDS-5]). The following data were collected: sex, age, educational history, whether the participants had visited a medical institution for diseases (hypertension, diabetes, hyperlipidemia, heart disease), and the presence/absence of established risk factors (hearing loss, history of head injury, drinking habits, smoking habits, social isolation, and physical inactivity and activity). Based on the KCL-CF, 96 and 145 participants were considered to have and lack SCCs, respectively. On logistic regression analysis, the AIS-J score and smoking history were significantly associated with SCCs. Our findings suggest that sleep disturbance is associated with SCC development among community-dwelling elderly people in Japan. Evaluating and managing sleep disturbances can be important in preventing SCCs and dementia.
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Affiliation(s)
- Akio Goda
- Hokuriku University Well-Being Research Team, Department of Physical Therapy, Faculty of Health and Medical Science, Hokuriku University, Kanazawa 920-1180, Japan
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Yuki Kikuchi
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Kohei Mori
- Faculty of Allied Health Sciences, Kansai University of Welfare Sciences, Kashiwara 582-0026, Japan
| | | | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
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Chen X, Li J, Liu J, Liu X, Deng M, Dong X, Yang Y. The association of sun-cured tobacco and cigarette use with global cognitive function, verbal fluency and memory in patients with chronic obstructive pulmonary disease: A cross-sectional study. Tob Induc Dis 2024; 22:TID-22-09. [PMID: 38229665 PMCID: PMC10789182 DOI: 10.18332/tid/175973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024] Open
Abstract
INTRODUCTION Some elderly people in China prefer sun-cured tobacco to cigarettes, and the composition of sun-cured tobacco and cigarettes is inconsistent. The influence of cigarettes on the cognitive function of COPD patients has been widely reported, but the research on sun-cured tobacco is relatively rare. Our study explored the association of sun-cured tobacco and cigarette use with cognitive decline in COPD patients. METHODS This was a cross-sectional study. A total of 401 COPD patients were included, and 190, 103, and 108 participants were included in non-smoking, cigarette-smoking, and sun-cured tobacco groups, respectively. We evaluated the global cognitive function using the Beijing version of the Montreal Cognitive Assessment, verbal fluency function using an animal fluency test, and memory function using ten unrelated words. RESULTS The participants of both cigarette-smoking (AOR=11.18; 95% CI: 1.28- 97.5) and sun-cured tobacco (AOR=10.46; 95% CI: 1.14-96.4) groups were more likely to develop mild cognitive impairment compared to the non-smoking group. The mean z scores of global cognitive function, verbal fluency, and memory were lower in cigarette-smoking and sun-cured tobacco groups than those in a non-smoking group; Multivariable linear regression showed that global cognitive function (β= -0.61; 95% CI: -1.04 - -0.18; and β= -0.48; 95% CI: -0.91 - -0.05) and verbal fluency (β= -0.79; 95% CI: -1.33 - -0.26; and β= -0.69; 95% CI: -1.23 - -0.16) of the sun-cured tobacco group and the cigarette-smoking group were significantly lower than those of the non-smoking group when adjusting for demographic and disease-related characteristics. However, there was no significant difference between the cigarette-smoking and sun-cured tobacco groups in global cognitive function, verbal fluency, and memory. CONCLUSIONS Compared with non-smokers, the use of cigarettes and sun-cured tobacco may damage the cognitive function of COPD patients, especially in global cognitive function and verbal fluency.
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Affiliation(s)
- Xiaomei Chen
- School of Nursing, Army Medical University, Chongqing, China
| | - Jie Li
- Department of Medicine, Qionglai Medical Center Hospital, Chengdu, China
| | - Jia Liu
- School of Nursing, Army Medical University, Chongqing, China
| | - Xiao Liu
- School of Nursing, Army Medical University, Chongqing, China
| | - Menghui Deng
- School of Nursing, Army Medical University, Chongqing, China
| | - Xunhu Dong
- Department of Chemical Defense Medicine, School of Military Preventive Medicine, Army Medical University, Chongqing, China
| | - Yanni Yang
- School of Nursing, Army Medical University, Chongqing, China
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Huang C, Ren X, Xu B, Liu P, Li T, Zhu Q, Huang J, Chen X, Wu D, Yang X, Zhu F, Liu J. Urinary nicotine metabolites are associated with cognitive impairment among the elderly in southern China. Tob Induc Dis 2023; 21:123. [PMID: 37799805 PMCID: PMC10548790 DOI: 10.18332/tid/170423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION This study comprehensively assessed the association between eight metabolites of urinary nicotine and cognitive impairment. METHODS This cross-sectional study was based on the data of Shenzhen Aging Related Disorder Cohort (SADC), including 51 elderly community data variables such as demographic characteristics, neuropsychological assessment and environmental factors, from July 2017 to November 2018. Participant's cognitive function was assessed by Mini-Mental State Examination (MMSE) scale and urinary nicotine metabolite [including cotinine N-β-D-glucuronide (CotGluc), rac 4-hydroxy-4-(3-pyridyl) butanoic acid dicyclohexylamine salt (HyPyBut), trans-3'-hydroxy cotinine O-β-D-glucuronide (OHCotGluc), and cotinine (Cot), etc.] concentrations were measured by high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). Generalized linear models and restricted cubic spline models were used to explore the relationships between the urinary levels of nicotine metabolite and cognitive function. RESULTS A total of 296 individuals aged >60 years were included. Individuals in the third quartile of CotGluc had a 0.786 point (95% CI: -1.244 - -0.329) decrease or in the highest quartile of OHCotGluc had a 0.804 point (95% CI: -1.330 - -0.278) decreased in attention and calculation compared to those in the lowest quartile (all p for trend <0.05). Compared with those in the lowest quartile, individuals in the highest quartile of CotGluc, HyPyBut, OHCotGluc and Cot, respectively, corresponded to a 1.043 point (95% CI: -2.269-0.182), 1.101 points (95% CI: -2.391-0.188), 2.318 points (95% CI: -3.615 - -1.020), and 1.460 points (95% CI: -2.726 - -0.194) decreased in MMSE total score (all p for trend <0.05). A non-linear dose-response relationship between urinary levels of CotGluc, HyPyBut, OHCotGluc or Cot and cognitive function (all overall p<0.05, non-linear p<0.05). Subgroup analysis showed that urinary levels of CotGluc, OHCotGluc or Cot were significantly negatively associated with cognitive function (all p for trend <0.05) among females and non-smokers. CONCLUSIONS The findings highlight the public health implications of environmental tobacco smoke exposure, and effective interventions need to be performed for vulnerable populations.
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Affiliation(s)
- Chao Huang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Xiaohu Ren
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Benhong Xu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Peiyi Liu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Tian Li
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Qinqin Zhu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Jia Huang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Xiao Chen
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Desheng Wu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Xifei Yang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Feiqi Zhu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, People’s Republic of China
| | - Jianjun Liu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
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