Zaciragic Asija, Dervisevic Amela, Valjevac Amina, Fajkic Almir, Spahic Selma, Hasanbegovic Ilvana, Jadric Radivoj, Lepara Orhan
Department of Human Physiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Department of Pathophysiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Mater Sociomed. 2022 Jun;34(2):100-106. doi: 10.5455/msm.2022.34.100-106.
Lipids and lipoproteins are significantly involved in maintaining structural and functional components of the human brain and neurons, but their role in the development of Alzheimer's disease (AD) and vascular dementia (VD) remains unclear.
The aim of the present study was to explore the differences in the standard and novel lipid profile parameters in patients with AD and VD, stratified by the degree of cognitive impairment (CI).
Present study included 66 patients with AD, 50 patients with VD, and 60 control subjects. For an evaluation of the global cognitive function the Montreal Cognitive Assessment (MoCA) test was used. In order to distinguish patients with VD from those with AD the Hachinski ischemic score was used. Plasma total cholesterol (TC), high-density lipoprotein -cholesterol (HDL-C), and triglycerides (TG) levels were determined using standard enzymatic colorimetric techniques, whereas the Friedewald formula was used to calculate low-density lipoprotein-cholesterol (LDL-C) levels. The non-traditional lipid indices such as TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C ratio were separately calculated. The differences between the groups were analyzed with the Kruskal Wallis test followed by the Mann-Whitney test or with ANOVA followed by the Tuckey posthoc test.
Results of the conducted study have found that the patients in AD group with moderate CI and patients in AD group with severe CI exhibited significantly lower levels of serum TC, TG, LDL-C, VLDL-C, Non- HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C and LDL-C/HDL-C compared to cognitively normal control subjects. Moreover, patients in VD group with severe and moderate CI had significantly lower level of TG compared to control group of subjects. Our results have also shown that patients in AD group with moderate CI had significantly lower level of TC, TG, LDL-C, Non-HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C compared to VD patients with moderate CI. In addition, patients in AD group with severe CI had significantly lower level of TC, LDL-C, Non-HDL-C and TC/HDL-C compared to VD patients with severe CI.
The results of this study have shown dysregulation of lipid metabolism in AD and VD patients with different degree of CI. In both moderate and in severe CI, patients with AD had lower levels of majority of standard and novel lipid parameters compared to patients with VD. Further larger prospective studies are required to elucidate the accuracy of standard and novel lipid parameters in the assessment of different degree of CI in AD and VD.
脂质和脂蛋白在维持人类大脑和神经元的结构及功能成分方面发挥着重要作用,但其在阿尔茨海默病(AD)和血管性痴呆(VD)发生发展中的作用仍不明确。
本研究旨在探讨AD和VD患者中,根据认知障碍(CI)程度分层的标准和新型脂质谱参数的差异。
本研究纳入66例AD患者、50例VD患者和60例对照者。采用蒙特利尔认知评估(MoCA)测试评估整体认知功能。为区分VD患者和AD患者,使用哈金斯基缺血评分。采用标准酶比色法测定血浆总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和甘油三酯(TG)水平,而用弗里德瓦尔德公式计算低密度脂蛋白胆固醇(LDL-C)水平。分别计算TG/HDL-C、TC/HDL-C和LDL-C/HDL-C比值等非传统脂质指标。组间差异采用Kruskal Wallis检验,随后进行Mann-Whitney检验,或采用方差分析,随后进行Tuckey事后检验。
本研究结果发现,与认知正常的对照者相比,中度CI的AD组患者和重度CI的AD组患者的血清TC、TG、LDL-C、极低密度脂蛋白胆固醇(VLDL-C)、非高密度脂蛋白胆固醇(Non-HDL-C)、致动脉粥样硬化指数、TG/HDL-C、TC/HDL-C和LDL-C/HDL-C水平显著降低。此外,与对照组相比,重度和中度CI的VD组患者的TG水平显著降低。我们的结果还表明,与中度CI的VD患者相比,中度CI的AD组患者的TC、TG、LDL-C、Non-HDL-C、致动脉粥样硬化指数、TG/HDL-C、TC/HDL-C水平显著降低。此外,与重度CI的VD患者相比,重度CI的AD组患者的TC-LDL-C、Non-HDL-C和TC/HDL-C水平显著降低。
本研究结果表明,不同程度CI的AD和VD患者存在脂质代谢失调。在中度和重度CI中,与VD患者相比,AD患者大多数标准和新型脂质参数水平较低。需要进一步开展更大规模的前瞻性研究,以阐明标准和新型脂质参数在评估AD和VD不同程度CI中的准确性。