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血清人神经趋化蛋白及人甲壳质酶蛋白40水平与老年阿尔茨海默症患者早期认知功能损害的关系

Relationships of serum human fractalkine and chitinase-3-like protein 1 levels with early cognitive impairment in elderly patients with Alzheimer's disease

    摘要
  • 摘要:
    目的 探讨血清人神经趋化蛋白(CX3CL1)、人甲壳质酶蛋白40(YKL-40)水平与老年阿尔茨海默症(AD)患者早期认知功能损害的关系。
    方法 选取2021年2月—2023年12月新乡医学院第二附属医院收治的110例AD患者作为AD组, 另选取本院同期健康体检者50例作为对照组。比较2组临床资料及血清CX3CL1、YKL-40水平，采用多因素Logistic回归模型分析AD患者认知功能损害的影响因素。根据简易精神状态量表(MMSE)评估结果将110例AD患者分为轻度认知障碍组(n=47)、中度认知障碍组(n=36)、重度认知障碍组(n=27)，并采用Spearman相关性分析法分析血清CX3CL1、YKL-40与MMSE评分、Administration认知评估量表第3版(ACE-Ⅲ)评分、蒙特利尔认知评估量表(MoCA)评分的关系。
    结果 AD组患者80岁以上比率、文化程度为小学及以下比率、吸烟史比率、饮酒史比率、合并糖尿病比率、合并高血压比率、AD家族史比率、独居比率及血清CX3CL1、YKL-40水平高于对照组，从不体育锻炼/体力劳动比率、MMSE评分、ACE-Ⅲ评分及MoCA评分低于对照组，差异有统计学意义(P < 0.05)。高龄、合并糖尿病、血清CX3CL1、YKL-40是AD患者认知功能损害的独立危险因素(P < 0.05), 大专及以上文化程度为AD患者认知功能损害的保护因素(P < 0.05)。与轻度认知障碍组相比，中度认知障碍组、重度认知障碍组血清CX3CL1、YKL-40水平偏高，与中度认知障碍组相比，重度认知障碍组血清CX3CL1、YKL-40水平偏高，差异有统计学意义(P < 0.05)。Spearman相关性分析发现，血清CX3CL1、YKL-40与MMSE评分、ACE-Ⅲ评分、MoCA评分均呈负相关(P < 0.05)。
    结论 血清CX3CL1、YKL-40在老年AD患者体内呈高表达，且与老年AD患者早期认知功能损害关系密切。

     

    Abstract:
    Objective To investigate the relationships of serum levels of human fractalkine (CX3CL1) and chitinase-3-like protein 1 (YKL-40) with early cognitive impairment in elderly patients with Alzheimer's disease (AD).
    Methods A total of 110 AD patients in the Second Affiliated Hospital of Xinxiang Medical University from February 2021 to December 2023 were selected as AD group, and 50 healthy individuals with physical examination during the same period were selected as control group. Clinical materials and serum levels of CX3CL1 and YKL-40 were compared between the two groups, and multivariate Logistic regression models were used to analyze the influencing factors of cognitive impairment in AD patients. Based on the Mini-Mental State Examination (MMSE) score, the 110 AD patients were divided into mild cognitive impairment group (n=47), moderate cognitive impairment group (n=36), and severe cognitive impairment group (n=27). Spearman correlation analysis was performed to explore the relationships of serum CX3CL1 and YKL-40 with MMSE score, Addenbrooke's Cognitive Examination-Ⅲ (ACE-Ⅲ) score, and Montreal Cognitive Assessment (MoCA) score.
    Results The AD group had higher proportions of patients aged over 80 years, with an education level of primary school or below, smoking history, alcohol consumption history, diabetes mellitus, hypertension, AD family history, and living alone as well as higher serum levels of CX3CL1 and YKL-40 compared to the control group; conversely, the AD group had a lower proportion of patients engaging in no physical exercise/labor, and lower MMSE, ACE-Ⅲ, and MoCA scores, with significant between-group differences (P < 0.05). Advanced age, diabetes mellitus, and high serum levels of CX3CL1 and YKL-40 were independent risk factors for cognitive impairment in AD patients (P < 0.05), while an education level of college or above was a protective factor (P < 0.05). Compared with the mild cognitive impairment group, the moderate and severe cognitive impairment groups had higher serum levels of CX3CL1 and YKL-40, and the severe cognitive impairment group had higher serum levels of CX3CL1 and YKL-40 than the moderate group, with significant between-group differences (P < 0.05). Spearman correlation analysis revealed that serum CX3CL1 and YKL-40 were negatively correlated with MMSE, ACE-Ⅲ, and MoCA scores (P < 0.05).
    Conclusion Serum CX3CL1 and YKL-40 are highly expressed in elderly AD patients, and are closely related to early cognitive impairment in elderly AD patients.

     

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