Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Parkinsonism Relat Disord. 2018 Jul;52:37-42. doi: 10.1016/j.parkreldis.2018.03.014. Epub 2018 Mar 19.
Progressive supranuclear palsy (PSP) was previously thought as a cause of atypical Parkinsonism. Although Cystatin C (Cys C) and low-density cholesterol lipoprotein-C (LDL-C) are known to play critical roles in Parkinsonism, it is unknown whether they can be used as markers to distinguish PSP patients from healthy subjects and to determine disease severity.
We conducted a cross-sectional study to determine plasma Cys C/HDL/LDL-C levels of 40 patients with PSP and 40 healthy age-matched controls. An extended battery of motor and neuropsychological tests, including the PSP-Rating Scale (PSPRS), the Non-Motor Symptoms Scale (NMSS), Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE), was used to evaluate the disease severity. Receiver operating characteristic (ROC) curves were adopted to assess the prognostic accuracy of Cys C/LDL-C levels in distinguishing PSP from healthy subjects.
Patients with PSP exhibited significantly higher plasma levels of Cys C and lower LDL-C. The levels of plasma Cys C were positively and inversely correlated with the PSPRS/NMSS and MMSE scores, respectively. The LDL-C/HDL-C ratio was positively associated with PSPRS/NMSS and GDS scores. The ROC curve for the combination of Cys C and LDL-C yielded a better accuracy for distinguishing PSP from healthy subjects than the separate curves for each parameter.
Plasma Cys C and LDL-C may be valuable screening tools for differentiating PSP from healthy subjects; while they could be useful for the PSP intensifies and severity evaluation. A better understanding of Cys C and LDL-C may yield insights into the pathogenesis of PSP.
进行性核上性麻痹（PSP）以前被认为是一种非典型帕金森病的病因。虽然胱抑素 C（Cys C）和低密度脂蛋白胆固醇脂蛋白-C（LDL-C）已知在帕金森病中发挥关键作用，但尚不清楚它们是否可用作标志物来区分 PSP 患者与健康受试者，并确定疾病严重程度。
我们进行了一项横断面研究，以确定 40 例 PSP 患者和 40 名年龄匹配的健康对照者的血浆 Cys C/HDL/LDL-C 水平。采用扩展的运动和神经心理学测试组合，包括 PSP 评定量表（PSPRS）、非运动症状量表（NMSS）、老年抑郁量表（GDS）和简易精神状态检查（MMSE），评估疾病严重程度。采用受试者工作特征（ROC）曲线评估 Cys C/LDL-C 水平在区分 PSP 与健康受试者中的预后准确性。
PSP 患者的血浆 Cys C 水平显著升高，LDL-C 水平显著降低。血浆 Cys C 水平与 PSPRS/NMSS 和 MMSE 评分分别呈正相关和负相关。LDL-C/HDL-C 比值与 PSPRS/NMSS 和 GDS 评分呈正相关。Cys C 和 LDL-C 联合的 ROC 曲线在区分 PSP 与健康受试者方面的准确性优于每个参数的单独曲线。
血浆 Cys C 和 LDL-C 可能是区分 PSP 与健康受试者的有价值的筛选工具；同时，它们可能有助于 PSP 加重和严重程度评估。对 Cys C 和 LDL-C 的更好理解可能会深入了解 PSP 的发病机制。
