血清α-突触核蛋白、微管相关蛋白1轻链3、载脂蛋白A1与帕金森病认知功能、疾病进展的关系

翟书鹏; 贾航; 周国平

doi:10.7619/jcmp.20232668

血清α-突触核蛋白、微管相关蛋白1轻链3、载脂蛋白A1与帕金森病认知功能、疾病进展的关系

The relationships of serum α-synuclein, microtubule-associated protein 1 light chain 3, apolipoprotein A1 with cognitive function and disease progression in Parkinson's disease

摘要

摘要:
目的检测α-突触核蛋白（α-synuclein）、微管相关蛋白1轻链3（LC3）、载脂蛋白A1（Apo A1）水平在帕金森病（PD）患者血清中的表达情况，以及三者与PD患者发生认知功能障碍（CI）、疾病进展的相关性。
方法选取96例PD患者作为研究组，另外选取同期体检健康者90例为对照组。根据蒙特利尔认知评估量表（MoCA）评分将患者分为CI组（42例）和认知功能正常组（54例）。根据Hoehn-Yahr（H-Y）分期量表将PD患者分为Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ期，其中Ⅰ~Ⅱ期PD患者纳入早期PD组（57例），Ⅲ~Ⅴ期PD患者纳入中晚期PD组（39例）。测定PD患者血清中α-synuclein、LC3、Apo A1水平。分析α-synuclein、LC3、Apo A1与H-Y分期的相关性。采用多因素Logistic回归分析筛选PD患者发生CI的影响因素。
结果研究组α-synuclein水平高于对照组，LC3、Apo A1水平低于对照组，差异有统计学意义（P < 0.05）；早期PD组α-synuclein水平低于中晚期PD组，LC3与Apo A1水平高于中晚期PD组，差异有统计学意义（P < 0.05）。血清α-synuclein水平与H-Y分期呈正相关（P < 0.05）。三者联合预测PD患者发生CI的曲线下面积（AUC）为0.925，大于α-synuclein、LC3、Apo A1单独预测的AUC（P < 0.05）。α-synuclein、LC3、Apo A1、高血压史是PD患者发生CI的影响因素（P < 0.05）。
结论 α-synuclein在PD合并CI患者血清中呈高表达，LC3、Apo A1呈低表达，三者与PD认知功能、疾病进展的关系密切。

Abstract:
Objective To detect the expressions of α-synuclein, microtubule-associated protein 1 light chain 3 (LC3) and apolipoprotein A1 (Apo A1) in serum of patients with Parkinson's disease (PD), and their correlations with cognitive function (CI) and disease progression.
Methods Ninety-six PD patients were selected as research group; another 90 healthy subjects were selected as control group. The patients were divided into CI group (42 cases) and cognitively normal group (54 cases) according to the Montreal Cognitive Assessment Scale (MoCA) score. PD patients were divided into stages Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ according to the Hoehn-Yahr (H-Y) Staging Scale, patients in stage Ⅰ to Ⅱ were included in early PD group (57 cases), and those with stage Ⅲ to Ⅴ were in middle and late PD group (39 cases). The levels of serum α-synuclein and LC3, PD and Apo A1 patients were determined. The correlations of α-synuclein, LC3, Apo A1 with H-Y staging were analyzed. Logistic regression analysis was applied to screen the influencing factors of occurrence of CI in PD patients.
Results Compared with the control group, the level of α-synuclein in the research group increased, and the levels of LC3 and Apo A1 decreased (P < 0.05); the level of α-synuclein in the early PD group was lower than that in the middle and late PD group, and the levels of LC3 and Apo A1 were higher than those in the middle and late PD group (P < 0.05); serum α-synuclein level was positively correlated with H-Y staging (P < 0.05). The area under the curve (AUC) of their combination to predict the occurrence of cognitive impairment in PD patients was 0.925, which was greater than prediction by α-synuclein, LC3, and Apo A1 alone (P < 0.05); α-synuclein, LC3, Apo A1, and history of hypertension were the influencing factors of CI in PD patients (P < 0.05).
Conclusion α-synuclein is highly expressed in the serum of patients with PD complicated with cognitive impairment, while the expression of LC3 and Apo A1 are low. The three are closely related to PD cognitive function and disease progression.

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