循环中的25(OH)D和1,25(OH)D作为多系统萎缩与帕金森病患者之间的差异生物标志物。
Circulatory 25(OH)D and 1,25(OH)D as differential biomarkers between multiple system atrophy and Parkinson's disease patients.
作者信息
Ogura Hiromu, Hatip-Al-Khatib Izzettin, Suenaga Midori, Hatip Funda Bolukbasi, Mishima Takayasu, Fujioka Shinsuke, Ouma Shinji, Matsunaga Yoichi, Tsuboi Yoshio
机构信息
Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Department of Medical Pharmacology, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
出版信息
eNeurologicalSci. 2021 Sep 23;25:100369. doi: 10.1016/j.ensci.2021.100369. eCollection 2021 Dec.
BACKGROUND AND PURPOSE
There is sufficient evidence to support vitamin D's noncalcemic effects and the role of vitamin D deficiency in the development of a wide range of neurological disorders. This study aimed to evaluate whether serum 25(OH)D and 1,25(OH) 2 D could be used as biomarkers to differentiate between healthy subjects (HS), multiple system atrophy (MSA) and Parkinson's disease (PD) patients of both genders.
METHODS
A total of 107 subjects were included in this study, divided into three groups: 1- HS ( = 61), 2- MSA patients ( = 19), and 3- PD patients ( = 27). The patients were assessed using UMSARS II, UPDRS III, H&Y, MMSE and MoCA rating scales. The levels of 25(OH)D and 1,25(OH) 2 D in serum were determined using the radioimmunoassay technique.
RESULTS
The levels of 25(OH)D and 1,25(OH) 2 D in HS were 26.85 +/- 7.62 ng/mL and 53.63 +/- 13.66 pg/mL respectively. 25(OH)D levels were lower in both MSA and PD by 61% and 50%, respectively ( = 0.0001 vs. HS). 1,25(OH) 2 D levels were lower in MSA by 29%( = 0.001 vs HS). There was a correlation between 25(OH)D and 1,25(OH) 2 D in MSA and PD, but not in HS. 1,25(OH) 2 D regressed with MMSE (β = 0.476, = 0.04, R 2 = 0.226) in MSA, and with UPDRS III (β = -0.432, = 0.024, R 2 = 0.187) and MoCA (β = 0.582, = 0.005,R 2 = 0.279) in PD. 25(OH)D displayed considerable differentiative strength between HS and MSA (Wald = 17.123, OR = 0.586, = 0.0001; AUC = 0.982, sensitivity and Youden index = 0.882, = 0.0001) and PD (Wald = 18.552, OR = 0.700, = 0.0001; AUC = 0.943, sensitivity = 0.889, YI = 0.791, = 0.0001). 1,25(OH) 2 D distinguished MSA from PD (Wald 16.178, OR = 1.117, P = 0.0001; AUC = 0.868, sensitivity = 0.926, Youden index =0.632, P = 0.0001). H&Y exhibited the highest sensitivity, AUC, and significant distinguishing power between MSA and PD.
CONCLUSIONS
Serum 25(OH)D and 1,25(OH) 2 D could be useful biomarkers for MSA and PD. 25(OH)D and H&Y provided the highest sensitivity and group classification characteristics.
背景与目的
有充分证据支持维生素D的非钙调节作用以及维生素D缺乏在多种神经系统疾病发生发展中的作用。本研究旨在评估血清25(OH)D和1,25(OH)₂D是否可作为生物标志物，用于区分健康受试者（HS）、多系统萎缩（MSA）患者和帕金森病（PD）患者，涵盖男女两性。
方法
本研究共纳入107名受试者，分为三组：1 - HS（n = 61），2 - MSA患者（n = 19），3 - PD患者（n = 27）。使用UMSARS II、UPDRS III、H&Y、MMSE和MoCA评分量表对患者进行评估。采用放射免疫分析技术测定血清中25(OH)D和1,25(OH)₂D的水平。
结果
HS组中25(OH)D和1,25(OH)₂D的水平分别为26.85±7.62 ng/mL和53.63±13.66 pg/mL。MSA组和PD组的25(OH)D水平分别比HS组低61%和50%（与HS组相比，P = 0.0001）。MSA组的1,25(OH)₂D水平比HS组低29%（与HS组相比，P = 0.001）。MSA组和PD组中25(OH)D与1,25(OH)₂D之间存在相关性，但HS组不存在。在MSA组中，1,25(OH)₂D与MMSE呈负相关（β = 0.476，P = 0.04，R² = 0.226）；在PD组中，1,25(OH)₂D与UPDRS III呈负相关（β = -0.432，P = 0.024，R² = 0.187），与MoCA呈正相关（β = 0.582，P = 0.005，R² = 0.279）。25(OH)D在区分HS与MSA（Wald = 17.123，OR = 0.586，P = 0.0001；AUC = 0.982，敏感性和尤登指数 = 0.882，P = 0.0001）以及HS与PD（Wald = 18.552，OR = 0.700，P = 0.0001；AUC = 0.943，敏感性 = 0.889，YI = 0.791，P = 0.0001）方面显示出显著的鉴别能力。1,25(OH)₂D在区分MSA与PD方面具有显著差异（Wald 16.178，OR = 1.117，P = 0.0001；AUC = 0.868，敏感性 = 0.926，尤登指数 = 0.632，P = 0.0001）。H&Y在区分MSA与PD方面表现出最高的敏感性、AUC和显著的鉴别能力。
结论
血清25(OH)D和1,25(OH)₂D可能是MSA和PD有用的生物标志物。25(OH)D和H&Y具有最高的敏感性和分组分类特征。
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