血管性痴呆患者血清可溶性凋亡因子水平及其与糖脂代谢的关系

Relationship between Serum Soluble Apoptosis Factors and Glucose & Lipid Metabolism in Patients with Vascular Dementia

目的探讨血管性痴呆患者血清可溶性凋亡因子——sFas和sFasL的水平,分析其在血管性痴呆发生发展中的作用及其与糖脂代谢的关系。方法选取2007年6月—2011年1月我院门诊和住院的血管性痴呆患者80例(观察组)及同期医院义诊的社区老年健康志愿者50例(对照组)。采用双抗体夹心酶联免疫吸附测定(ELISA)法检测两组受检者血清sFas、sFasL水平,并检测观察组患者的血脂〔总胆固醇(TC)、三酰甘油(TG)〕、血糖、糖化血红蛋白(HbA1c)水平,测量身高、体质量,计算体质指数(BMI),并行简易精神状态量表(MMSE)、缺血指数量表(HACHINSKI)调查以评定认知功能。结果观察组患者血清sFas、sFasL水平分别为(146.1±10.0)、(228.3±10.4)μg/L,均高于对照组的(62.4±22.6)、(82.3±18.7)μg/L(t值分别为20.883、14.453;均P<0.01)。Pearson相关分析显示,观察组患者血清sFas水平与HACHINSKI评分呈负相关(r=-0.714,P<0.01),而与BMI、TC、HbA1c、MMSE评分呈正相关(r值分别为0.352、0.472、0.449、0.799;均P<0.01)。血清sFasL水平与TG水平呈负相关(r=-0.285,P<0.01),而与空腹血糖、HbA1c水平呈正相关(r值分别为0.521、0.856;均P<0.01)。血清TC水平与MMSE评分呈正相关(r=0.394,P<0.01),与HACHINSKI评分呈负相关(r=-0.418,P<0.01)。结论血管性痴呆患者血清sFas、sFasL水平均高于健康者;血管性痴呆的发病过程中可能存在细胞凋亡,并且血清sFas、sFasL水平可能与患者的认知功能、糖脂代谢相关。

Objective To investigate levels of serum soluble apoptosis factors(sFas and sFasL) in the patients with vascular dementia,to analyze its role in vascular dementia development and its relationship with glucose & lipid metabolism.Methods From June 2007 to January 2011,80 inpatient and outpatient patients with vascular dementia were included in observational group,50 community old healthy volunteers who took part in hospital free clinic were included in control group.The serum levels of sFas and sFasL in two groups were detected by enzyme-linked immunosorbent assay(ELISA).In observational group,the levels of TC,TG,blood sugar,HbA 1c were determined,BMI was calculated,and cognitive function was evaluated by MMSE and HACHINSKI.Results The serum levels of sFas and sFasL in observational group were(146.1 ± 10.0) μg / L and(228.3 ± 10.4) μg / L,serum levels of sFas and sFasL in control group were(62.4 ± 22.6) μg / L and(82.3 ± 18.7) μg / L,serum levels of sFas and sFasL in observational group were significantly higher than those in control group(t = 20.883 and 14.453,separately;both P < 0.01).According to results of Pearson correlation analysis,sFas level was negatively correlated with the scores of HACHINSKI(r =-0.714,P < 0.01) and was positively correlated with BMI,total cholesterol level,HbA 1c level,the scores of MMSE(r = 0.352,0.472,0.449 and 0.799,separately;all P < 0.01).sFasL level was negatively correlated with TG(r =-0.285,P < 0.01),and was positively correlated with fasting plasma glucose,HbA 1c(r = 0.521 and0. 856,separately; P < 0. 01). Serum level of TC was positively correlated with MMSE scores( r = 0. 394,P < 0. 01),and was negatively correlated with HACHINSKI scores( r =- 0. 418,P < 0. 01). Conclusion Serum level of sFas and sFasL in patients with vascular dementia are higher than those in healthy people. Apoptosis may be involved in vascular dementia development,and the serum levels of sFas and sFasL might correlated with cognition function and glucose & lipid metabolism.