Li Jun, Wang Qin, Qian Jingjuan, Chen Xiaodong, Li Dan, Song Chunjie
Department of Neurology, Suqian First Hospital Suqian 223800, Jiangsu, China.
Am J Transl Res. 2023 Jun 15;15(6):4110-4117. eCollection 2023.
This study was designed to analyze the associations of serum Orexin-A level with cognitive function and serum inflammatory cytokines in epileptic patients.
Totally 77 epileptic patients treated in Suqian First Hospital between January 2019 and January 2022 were retrospectively analyzed as the observation group, and 65 healthy individuals who had a physical examination in Suqian First Hospital during the same period were enrolled as the control group. The Mini-Mental State Examination (MMSE) was conducted in participants in the two groups, and the enzyme-linked immunosorbent assay (ELISA) was conducted for quantifying serum Orexin-A, interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Additionally, the Pearson correlation test was used for analyzing the associations of Orexin-A with MMSE, IL-1β, IL-6, and TNF-α in the patients, and receiver operating characteristic (ROC) curves were drawn for determining the diagnostic value of Orexin-A in epilepsy and cognitive dysfunction in epileptic patients. The independent risk factors for cognitive impairment in epileptic patients were analyzed by multivariate logistic regression analysis.
Epileptic patients showed a significantly lower serum Orexin-A level than the control group (P < 0.05), and the area under the curve (AUC) of Orexin-A in epilepsy diagnosis was 0.879. Additionally, epileptic patients had notably lower MMSE scores than the control group (P < 0.05). The Pearson correlation test revealed a positive association of Orexin-A with MMSE score and negative correlations of Orexin-A with IL-1β, IL-6, and TNF-α levels (P < 0.05). The AUC of Orexin-A in diagnosing cognitive dysfunction in epileptic patients was 0.908. According to multivariate analysis, lower education level, more severe EEG abnormalities and a lower Orexin-A level were independent risk factors for cognitive impairment in epileptic patients.
Orexin-A can act as a diagnostic marker for epileptic patients, and its level is positively related with cognitive function of patients, but negatively related to the degree of inflammation. It is promising to be an early warning index for epilepsy and cognitive dysfunction in patients.
本研究旨在分析癫痫患者血清食欲素A水平与认知功能及血清炎症细胞因子之间的关联。
回顾性分析2019年1月至2022年1月在宿迁市第一医院接受治疗的77例癫痫患者作为观察组，同期在宿迁市第一医院进行体检的65例健康个体作为对照组。对两组参与者进行简易精神状态检查表（MMSE）测试，并采用酶联免疫吸附测定法（ELISA）定量检测血清食欲素A、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）。此外，采用Pearson相关性检验分析患者食欲素A与MMSE、IL-1β、IL-6和TNF-α之间的关联，并绘制受试者工作特征（ROC）曲线以确定食欲素A对癫痫及癫痫患者认知功能障碍的诊断价值。通过多因素逻辑回归分析癫痫患者认知障碍的独立危险因素。
癫痫患者血清食欲素A水平显著低于对照组（P<0.05），食欲素A在癫痫诊断中的曲线下面积（AUC）为0.879。此外，癫痫患者的MMSE评分显著低于对照组（P<0.05）。Pearson相关性检验显示食欲素A与MMSE评分呈正相关，与IL-1β、IL-6和TNF-α水平呈负相关（P<0.05）。食欲素A在诊断癫痫患者认知功能障碍中的AUC为0.908。多因素分析显示，较低的教育水平、更严重的脑电图异常和较低的食欲素A水平是癫痫患者认知障碍的独立危险因素。
食欲素A可作为癫痫患者的诊断标志物，其水平与患者认知功能呈正相关，但与炎症程度呈负相关。有望成为癫痫及患者认知功能障碍的预警指标。
