Evlice Ahmet, Sanli Zeynep Selcan, Boz Pinar Bengi
Ahmet Evlice, MD. Department of Neurology, Faculty of Medicine, Cukurova University, Adana, Turkey.
Zeynep Selcan Sanli, MD., Faculty of Medicine, Neurology Clinic Health Sciences University Adana, Adana City Training and Research Hospital, Adana, Turkey.
Pak J Med Sci. 2023 May-Jun;39(3):799-803. doi: 10.12669/pjms.39.3.7024.
Ischemia and inflammation play a role in the pathophysiology of Alzheimer's disease (AD). Plasma neutrophil-lymphocyte ratio (NLR), and 25- hydroxyvitamin D (vitamin D) were used as a biomarker for inflammation and atherosclerosis. The present study aimed to investigate a link between NLR, vitamin D and ischemia in AD.
The subjects with AD and control groups were enrolled to this retrospective study between 2017-2022 at Cukurova University Hospital. The cognitive assessment (MMSE), and blood tests (NLR, vitamin D) were collected from all subjects. In first part of the study, AD (n:132) and the control group (n:38) were compared. In second part of the study, magnetic resonance imaging (MRI) was used for evaluating ischemic lesions with scoring method of Fazekas. The control group (n:38) and AD subjects with mild ischemic lesions (Fazekas-1 and Fazekas-2) (n:64) were excluded. AD subjects with severe ischemic lesions (Fazekas-3) (n:34) and without ischemic lesions (Fazekas-0) (n:34) were compared again. SPSS 20.0 was used for all analyses. The threshold for statistical significance was set at 0.05.
In the first part of the study, 132 AD patients (69 female and 63 male; mean age 70.83±9.35 (49-87) and age-matched 38 controls were compared. The mean NLR in AD [2.96±2.46 (1.17-19.43)] was higher than the control group [1.9±0.66 (0.9-3.56)] (p=0.005). In the second part of the study, the mean Vitamin D of Fazekas-3 AD group [16.15±9.64 (4.7-35)] was lower than Fazekas-0 AD group [16.27±6.81(4.6-29.7)] (p=0.024).
NLR was higher in AD while there was no difference between the Fazekas-0 and Fazekas-3 AD groups. Vitamin D was lower in the Fazekas-3 AD group. These data suggested that NLR increased independently of ischemia in AD. Also vitamin D deficiency could trigger ischemia in AD.
缺血和炎症在阿尔茨海默病（AD）的病理生理学中起作用。血浆中性粒细胞与淋巴细胞比值（NLR）和25-羟基维生素D（维生素D）被用作炎症和动脉粥样硬化的生物标志物。本研究旨在探讨AD中NLR、维生素D与缺血之间的联系。
2017年至2022年期间，在库库洛瓦大学医院对AD患者和对照组进行了这项回顾性研究。收集了所有受试者的认知评估（MMSE）和血液检查（NLR、维生素D）。在研究的第一部分，比较了AD组（n = 132）和对照组（n = 38）。在研究的第二部分，使用磁共振成像（MRI）以法泽卡斯评分法评估缺血性病变。排除了对照组（n = 38）和轻度缺血性病变（法泽卡斯1级和2级）的AD受试者（n = 64）。再次比较了重度缺血性病变（法泽卡斯3级）的AD受试者（n = 34）和无缺血性病变（法泽卡斯0级）的AD受试者（n = 34）。所有分析均使用SPSS 20.0。统计学显著性阈值设定为0.05。
在研究的第一部分，比较了132例AD患者（69例女性和63例男性；平均年龄70.83±9.35岁（49 - 87岁））和年龄匹配的38例对照组。AD组的平均NLR[2.96±2.46（1.17 - 19.43）]高于对照组[1.9±0.66（0.9 - 3.56）]（p = 0.005）。在研究的第二部分，法泽卡斯3级AD组的平均维生素D[16.15±9.64（4.7 - 35）]低于法泽卡斯0级AD组[16.27±6.81（4.6 - 29.7）]（p = 0.024）。
AD患者的NLR较高，而法泽卡斯0级和3级AD组之间无差异。法泽卡斯3级AD组的维生素D较低。这些数据表明，AD中NLR的升高与缺血无关。此外，维生素D缺乏可能引发AD中的缺血。
