联合检测血清同型半胱氨酸、C 反应蛋白和血清铁蛋白在轻度认知障碍和阿尔茨海默病中的诊断准确性。
Diagnostic Accuracy of Combined Measurement of Serum Homocysteine, C-Reactive Protein, and Serum Ferritin in Mild Cognitive Impairments and Alzheimer's Disease.
机构信息
Department of Clinical Laboratory, Affiliated Hospital of Hebei University, Baoding, China.
Department of Radiology, Affiliated Hospital of Hebei University, Baoding, China.
出版信息
J Coll Physicians Surg Pak. 2024 Nov;34(11):1303-1308. doi: 10.29271/jcpsp.2024.11.1303.
OBJECTIVE
Evaluation of the diagnostic accuracy of combined detection of serum homocysteine (Hcy), C-reactive protein (CRP), and serum ferritin (SF) levels in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI).
STUDY DESIGN
Descriptive study. Place and Duration of the Study: Clinical Laboratory Section, Affiliated Hospital of Hebei University, Baoding, Heibei, China, from May 2022 to June 2023.
METHODOLOGY
Data of 120 patients with memory decline were retrospectively collected. They were divided into an MCI group and an AD group. A further 50 healthy participants were used as a normal control (NC) group. Differences in the Hcy, CRP, and SF levels between the three groups were evaluated. The specificity, accuracy, and sensitivity of these three indices in the combined or single diagnosis of AD and MCI were compared. Their associations with the severity of AD and MCI were also compared.
RESULTS
The AD group had the highest levels of Hcy, CRP, and SF (18.79 ± 4.50, 6.35 ± 2.04, and 355.69 ± 120.36), followed by MCI (16.75 ± 3.06, 4.58 ± 2.31, and 203.48 ± 12.76), and NC group (14.32 ± 2.06, 2.06 ± 0.76, and 98.46 ± 5.06), with statistically significant differences (all p <0.001). The diagnostic efficacy of AD for CRP was 98.50%, sensitivity was 96.00%, and specificity was 94.00%, which was higher than Hcy and SF. Tested together, the area under the ROC curve was 99.90%, specificity was 98.00%, and sensitivity was 98.00%. The diagnostic efficacy of SF for MCI had sensitivity of 100.00%, and specificity of 100.00%, which was higher than that of Hcy and CRP. When the three were combined for detection, the area under the curve of SF was 100.00%, sensitivity of 100.00%, and specificity of 100.00%. The levels of Hcy, CRP, and SF were positively correlated with the severity of AD (p <0.01), while negatively correlated with the mini-mental state examination (MMSE) score (p <0.01).
CONCLUSION
The combined detection of Hcy, CRP, and SF improved the diagnostic accuracy of comorbid AD and MCI.
KEY WORDS
Homocysteine, C-reactive protein, Cognitive impairment, Serum ferritin, Alzheimer's disease.
目的
评估联合检测血清同型半胱氨酸（Hcy）、C 反应蛋白（CRP）和血清铁蛋白（SF）水平对阿尔茨海默病（AD）和轻度认知障碍（MCI）患者的诊断准确性。
研究设计
描述性研究。地点和研究时间：中国河北大学附属医院临床检验科，2022 年 5 月至 2023 年 6 月。
方法
回顾性收集了 120 名记忆减退患者的数据。他们被分为 MCI 组和 AD 组。另外 50 名健康参与者作为正常对照组（NC）。评估三组之间 Hcy、CRP 和 SF 水平的差异。比较这三个指标在 AD 和 MCI 联合或单独诊断中的特异性、准确性和敏感性。还比较了它们与 AD 和 MCI 严重程度的关系。
结果
AD 组 Hcy、CRP 和 SF 水平最高（18.79±4.50、6.35±2.04 和 355.69±120.36），其次是 MCI 组（16.75±3.06、4.58±2.31 和 203.48±12.76），NC 组最低（14.32±2.06、2.06±0.76 和 98.46±5.06），差异有统计学意义（均 p<0.001）。CRP 对 AD 的诊断效能为 98.50%，灵敏度为 96.00%，特异性为 94.00%，高于 Hcy 和 SF。联合检测时，ROC 曲线下面积为 99.90%，特异性为 98.00%，灵敏度为 98.00%。SF 对 MCI 的诊断效能具有 100.00%的灵敏度和 100.00%的特异性，高于 Hcy 和 CRP。当三者联合检测时，SF 的曲线下面积为 100.00%，灵敏度为 100.00%，特异性为 100.00%。Hcy、CRP 和 SF 水平与 AD 的严重程度呈正相关（p<0.01），与简易精神状态检查（MMSE）评分呈负相关（p<0.01）。
结论
联合检测 Hcy、CRP 和 SF 提高了共病 AD 和 MCI 的诊断准确性。
关键词
同型半胱氨酸；C 反应蛋白；认知障碍；血清铁蛋白；阿尔茨海默病。
Zotero 插件