認知的フレイルの診断に有効な血液バイオマーカー候補を発見

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2025-12-05 長寿医療研究センター研究所

国立長寿医療研究センターと広島大学の研究チームは、認知機能低下と身体的フレイルが併存する「認知的フレイル」を対象に、臨床情報、RNA-seq、ELISA、メタボローム解析を統合したマルチオミクス解析を実施し、GDF15、BDNF、アディポネクチン、ミリスチン酸、ニコチンアミド、γ-ブチロベタインの6種を新たな血液バイオマーカー候補として同定した。特に GDF15・ミリスチン酸・ニコチンアミド が、ランダムフォレスト解析で高い診断精度を示し、身体機能指標(J-CHS)や認知評価(MMSE-J、MoCA-J)とも強く相関した。ミリスチン酸やニコチンアミドは栄養素として補充可能であり、将来的な予防介入への応用も期待される。本研究は、血液から客観的に認知的フレイルを診断する手法の確立に向けた重要な一歩である。

認知的フレイルの診断に有効な血液バイオマーカー候補を発見
図1 予測モデルの結果

<関連情報>

認知機能の虚弱性を示す血液バイオマーカーの検出に向けた統合的アプローチ An integrative approach to detecting potential blood-based biomarkers of cognitive frailty

Motoki Furutani, Mutsumi Suganuma, Tohru Hosoyama, Risa Mitsumori, Marie Takemura, Yasumoto Matsui, Yukiko Nakano, Shumpei Niida, Kouichi Ozaki, Shosuke Satake, Daichi Shigemizu
The Journal of nutrition, health and aging  Available online: 24 November 2025
DOI:https://doi.org/10.1016/j.jnha.2025.100726

Highlights

  • Cognitive frailty, defined by the coexistence of cognitive decline and physical frailty, presents significant health risks.
  • We identified three promising biomarkers: GDF15, myristic acid, and nicotinamide.
  • Low plasma myristic acid levels were crucial in predicting cognitive frailty, emphasizing their potential as a biomarker.

Abstract

Objective

Cognitive frailty, defined by the coexistence of cognitive decline and physical frailty, has been clinically defined, but its biological clues are still vague. This underscores the need for promising blood-based molecular biomarkers.

Design

Cross-sectional observational study.

Settings and participants

Frailty was diagnosed using the Japanese version of the Cardiovascular Health Study (J-CHS), and mild cognitive impairment was assessed with the Japanese version of the Montreal Cognitive Assessment (MoCA-J) and Mini-Mental State Examination-Japanese (MMSE-J). Participants with MMSE-J ≥24, MoCA-J score ≤25, and J-CHS score ≥1 were classified as having cognitive frailty. This study included 87 older adults aged ≥65 years, comprising 44 robust and 43 with cognitive frailty.

Measurements

Blood samples and associated clinical data were obtained from the National Center for Geriatrics and Gerontology Biobank in Japan. A multi-omics analysis integrating clinical data, RNA-seq, aging-related factors, and metabolomics were conducted to identify potential biomarkers through logistic regression, adjusting for age, sex, and body mass index (BMI). An optimal set of biomarkers was determined by constructing prediction models using the random forest algorithm.

Results

Three candidate biomarkers were identified from aging-related factors—growth differentiation factor (GDF15), brain-derived neurotrophic factor (BDNF), and Adiponectin—and three from metabolomics—myristic acid, nicotinamide, and γ-butyrobetaine. Using combinations of these candidates with clinical variables, we constructed risk prediction models. The best model incorporated one aging-related factors (GDF15) and two metabolites (myristic acid, and nicotinamide), achieving a high area under the receiver operating characteristic curve (AUC) of 0.96 in an independent validation cohort. This was significantly higher than models based solely on clinical information (age, sex, and BMI) (Welch’s t-test, p <0.001). Among these biomarkers, myristic acid showed the highest influence, with a median Gini importance of 0.38 (95% confidence interval: 0.29–0.47).

Conclusions

We identified three promising biomarkers—GDF15, myristic acid, and nicotinamide—for cognitive frailty. Notably, low plasma myristic acid levels emerged as the most significant contributor to the prediction model. Further refinement and large-scale validation will be essential to support its future clinical application.

医療・健康
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