血生化指标与老年人帕金森病患病风险的相关性研究

Investigation of the correlation between serum biochemical parameters and Parkinsoffs disease risk in the elderly

目的分析并探讨血生化指标与老年人帕金森病患病风险的相关性。方法收集自2009年1月至2013年12月在江苏省人民医院确诊为帕金森病的患者277例作为帕金森病组；收集年龄与性别相匹配的同期健康体检者277例作为对照组，检测两组患者总胆固醇、尿酸、总胆红素、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平并进行比较。结果帕金森病组总胆固醇、尿酸、总胆红素、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平（4．35±1．13）mmol／L、（278．00±101．89）μmol／L、（13．02±7．56）μmol／L、（1．26±0．37）mmol／L、（2．59±0．79）mmol／L，均低于对照组（4．95±0．98）mmol／L（380．90±108．28）μmol／L（17．39±7．30）μmol／L（1．34±0．28）mmol／L（3．17±0．91）mmol／L（t=6．63、12．44、7．09、3．38、7．42，均P〈0．05）。经多因素Logistic回归分析显示总胆红素、尿酸、低密度脂蛋白胆固醇与帕金森病的发生独立相关（OR=0．940、0．991、0．219，均P〈0．001）。采用受试者工作特征曲线（ROC）的曲线下面积（AUC）对总胆红素、血尿酸、低密度脂蛋白胆固醇进行诊断实验评估，并采用线性加权法综合3项预测指标构建合并值进行评估，结果显示，曲线下面积分别为0．713、0．765、0．682和0．809，且合并值价值最高（均P〈0．001）。结论尿酸、总胆红素和低密度脂蛋白胆固醇水平下降与帕金森病的发生独立相关，对评估帕金森病风险具有一定的临床价值。

Objective To investigate the correlation between serum biochemical parameters and Parkinson＇s disease （PD） risk in the elderly. Methods The 277 inpatients with PD as PD group in Jiangsu Province Hospital from January 2009 to December 2013 were selected, at the same time, the 277 age and gender-matched healthy persons were enrolled as control group. The levels of total cholesterol （TG）, total bilirubin （TB）, uric acid （UA）, low-density lipoprotein cholesterol （LDL-C） and high-density lipoprotein cholesterol （HDL-C） were detected and compared between the two groups. Results The levels of TG, UA, TB, HDL-C and LDL-C were significantly lower in PD group than in control group [（4. 35±1.13） mmol/L vs. （4.95±0.98） mmol/L, t=6.63; （278. 00± 101.89）μmol/L vs. （380.90 ± 108. 28）μmol/L, t = 12.44; （13.02 ± 7.56）μmol/L vs. （ 17.39 ± 7.30）μmol/L, t=7.09; （1.26±0. 37） mmol/L vs. （1. 34±0. 28） mmol/L, t=3.38; （2.59±0. 79） mmol/L vs. （3. 17±0.91） mmol/L, t=7.42, all P〈0.05]. Logistic multiple regression analysis showed that the decreased levels of TB, UA and LDL-C were independently associated with prevalence risk of PD （OR=0. 940, 0. 991 and 0. 219, all P〈0. 001）. The combined score of TB, UA and LDL-C was constructed by using the linear weighted method. ROC curve was drawn to select the higher diagnostic validity index among TB, UA, LDL-C and combined score. The area under the ROC curve for TB, UA, LDL-C and combined score was 0. 713, 0. 765, 0. 682 and 0. 809 （all P^0. 001）, and the value of combined score was the highest. Conelmions The decreased levels of TB, UA and LDL-C are independently associated with PD. They possess certain clinical value in evaluating the prevalence risk of PD. [Key words] Parkinson＇s disease; Uric acid; Bilirubin