血清 ANGPTL4 水平与脑小血管病患者脑白质高信号和认知障碍的相关性。
Correlation between serum ANGPTL4 levels and white matter hyperintensity and cognitive impairment in patients with cerebral small vessel disease.
机构信息
Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Department of Neurology, First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
出版信息
Brain Behav. 2024 Feb;14(2):e3401. doi: 10.1002/brb3.3401.
OBJECTIVES
To investigate the correlation between serum angiopoietin-like protein 4 (ANGPTL4) levels, white matter hyperintensity (WMH), and cognitive impairment (CI) in patients with cerebral small vessel disease (CSVD).
METHODS
This cross-sectional study enrolled 171 patients with CSVD who attended the First Affiliated Hospital of Xinxiang Medical University from December 2021 to July 2022. All subjects underwent a 3.0T head magnetic resonance imaging, neuropsychology assessment, and blood sampling. Serum ANGPTL4 levels were detected by enzyme-linked immunosorbent assay and the severity of WMH was assessed by the Fazekas scale. According to the Montreal Cognitive Assessment (MoCA) scale, subjects were divided into normal cognition group (NC, n = 80) and CI group (n = 91). According to the total Fazekas scores, subjects were divided into a mild WMH group (n = 84), a moderate WMH group (n = 70), and a severe WMH group (n = 17).
RESULTS
Serum ANGPTL4 levels were significantly higher in the CI group than in the NC group (p < .05) and were negatively correlated with mini-mental state examination scores and MoCA scores (r = -0.26, -0.341, p < .05). Serum ANGPTL4 levels increased significantly in the mild to moderate WMH group but tended to decrease in the severe WMH group. Binary logistic regression analysis showed that ANGPTL4 was an independent influencing factor for CSVD-CI (OR = 2.062, 95% CI (1.591-2.674), p < .001). The area under curve of ANGPTL4 for CSVD-CI was 0.847 (0.791-0.903).
CONCLUSION
ANGPTL4 may be involved in the process of white matter damage and CI in CSVD patients and shows a diagnostic value for CSVD-CI.
目的
探讨血清血管生成素样蛋白 4（ANGPTL4）水平与脑小血管病（CSVD）患者脑白质高信号（WMH）和认知障碍（CI）的相关性。
方法
本横断面研究纳入了 2021 年 12 月至 2022 年 7 月新乡医学院第一附属医院收治的 171 例 CSVD 患者。所有患者均接受了 3.0T 头部磁共振成像、神经心理学评估和血液采样。通过酶联免疫吸附试验检测血清 ANGPTL4 水平，采用 Fazekas 量表评估 WMH 严重程度。根据蒙特利尔认知评估量表（MoCA），患者分为正常认知组（NC，n=80）和 CI 组（n=91）。根据总 Fazekas 评分，患者分为轻度 WMH 组（n=84）、中度 WMH 组（n=70）和重度 WMH 组（n=17）。
结果
CI 组血清 ANGPTL4 水平明显高于 NC 组（p<0.05），且与简易精神状态检查评分和 MoCA 评分呈负相关（r=-0.26、-0.341，p<0.05）。轻度至中度 WMH 组血清 ANGPTL4 水平显著升高，重度 WMH 组则呈下降趋势。二元逻辑回归分析显示，ANGPTL4 是 CSVD-CI 的独立影响因素（OR=2.062，95%CI（1.591-2.674），p<0.001）。ANGPTL4 对 CSVD-CI 的曲线下面积为 0.847（0.791-0.903）。
结论
ANGPTL4 可能参与 CSVD 患者脑白质损伤和 CI 的发生过程，对 CSVD-CI 具有诊断价值。
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