尿液Fractalkine水平与轻度认知功能障碍相关性研究

Study of the correlation between urinary Fractalkine level and mild cognitive impairment

目的:探讨轻度认知功能障碍(MCI)患者尿液神经趋化蛋白Fractalkine(Fkn,也称CX3CL1)水平与认知功能的关系,探讨尿液Fkn水平对MCI的诊断价值,为临床MCI提供新的诊断和疾病监测标志物。方法:受试者分MCI组(25例)和年龄与性别匹配的认知功能正常组(对照组,26例),使用酶联免疫吸附法(ELISA)测定MCI患者和对照者尿液Fkn浓度。尿液Fkn水平使用尿液Fkn浓度和尿液肌酐(creatinine,Cr)浓度的比值表示。采用简易精神状态量表(MMSE)、日常生活活动能力量表(ADL)、临床痴呆评定量表(CDR)等量表进行认知功能评分,并分析尿液Fkn水平与认知功能评分的相关性。受试者工作特征曲线(ROC)曲线评价尿液Fkn水平诊断MCI的敏感性和特异性。结果:MCI组患者尿液Fkn平均水平明显低于对照组(0.87±0.59ng Fkn/mg Crvs1.96±1.27ng Fkn/mg Cr,P<0.01)。尿液Fkn水平与MMSE评分(r=0.429,p<0.01)、ADL评分(r=-0.471,p<0.01)和CDR评分(r=-0.450,p<0.01)具有相关性。ROC曲线分析显示尿液Fkn水平诊断MCI的敏感性为57.7%,特异性为88.0%。结论:尿液Fkn水平在MCI患者中表达下降,尿液Fkn与认知功能损害具有相关性。尿液Fkn可以作为检测MCI病情程度和疾病进展的无创性参考指标之一。

Objective Toinvestigate the relationship between urinary Fractalkine(Fkn,CX3 CL1)level and cognitive function in patients with mild cognitive impairment(MCI),and to explore the value of urinary Fractalkine for diagnosis of MCI,so as to provide new markers for diagnostic and disease monitoring for clinical MCI.Methods Urine samples of 25 patients with MCI(MCI group),and 26 ageand gender-matched normal cognitive function controls(Control group)were collected in this study.Urinary Fkn concentrations were measured by enzyme-linked immunosorbent assay(ELISA),urinary Fkn levels were calculated with the ratio of urinary Fkn concentrations to urinary creatinine.We investigated the correlation of urinary Fkn levels with mini-mental state examination(MMSE)scores,activities of daily living(ADL)scores and clinical dementia rating(CDR)scores.Receiver operating characteristic(ROC)curve was used to investigate the sensitivity and specificity of Fkn in diagnosing MCI.Results The urinary Fkn level of the MCI group(0.87±0.59 ng Fkn/mg Creatinine)was significantly lower than that of Control group(1.96±1.27 ng Fkn/mg Creatinine)(p<0.01).Urinary Fkn levels were significantly correlated with MMSE scores(r=0.429,p<0.01),ADL scores(r=0.471,p<0.01),CDR scores(r=0.450,p<0.01).The area under curve for urinary Fkn MCI versus Control was 0.76,the sensitively and specificity of urinary Fkn for distinguishing MCI from Control was 57.7%and 88.0%,respectively.Conclusions MCI patients had lower urinary Fkn level.There were significantly correlations with urinary Fkn levels and severity of cognitive impairment.Urinary Fkn levels maybe a potential biomarker of MCI.