RBP4对糖尿病肾病无症状脑梗死神经认知功能的影响

Effect of RBP4 on neurocognitive function in diabetic nephropathy with silent cerebral infarction

目的探讨血清视黄醇结合蛋白4(RBP4)对糖尿病肾病(DN)无症状脑梗死(SCI)患者神经认知功能的损害及其发病机制。方法选取60例新诊断DN患者和30例健康志愿者为研究对象,根据影像学结果将60例DN患者分成并发SCI组(SCI组)和未并发SCI组(NSCI组),每组30例,评估神经功能缺损程度和蒙特利尔认知评估量表,ELISA检测RBP4水平,Western blot检测脂蛋白相关磷脂酶A2(Lp-PLA2)和趋化因子受体4(CXCR4)表达。结果与NSCI组比较,SCI组患者神经认知功能减退,RBP4、Lp-PLA2和CXCR4表达水平均增高(P<0.05)。RBP4水平与SCI患者神经认知功能损害呈正相关,且RBP4与糖尿病并发SCI存在回归关系。结论血清RBP4可作为DN并发SCI预测因子,其与神经认知功能损害呈正相关,LpPLA2/CXCR4通路活化可能是其发病机制之一。

Objective To observe the impairment effect of retinol binding protein 4（RBP4）on neurocognitive function in diabetic nephropathy（DN）patients with silent cerebral infarction（SCI）and to explore its mechanism.Methods Sixty patients with newly diagnosed DN and 30 healthy volunteers were selected as the study subjects and the DN cases were divided into the complicating SCI group（SCI,n=30）and non-complicating SCI group（NSCI,n=30）according to the imaging results.The degrees of neurological function deficit and Montreal cognitive assessment（MoCA）were evaluated.Serum RBP4 level was determined by ELISA and expressions of Lp-PLA2 and C-X-C chemokine receptor type 4（CXCR4）were determined by Western blot.Results Compared with the NSCI group,the neurocognitive function in the SCI group was subsided,the expression levels of RBP4,Lp-PLA2 and CXCR4 were increased（P〈0.05）.The RBP4 level was positively correlated with the neurocognitive function impairment in SCI patients,moreover,there existed a regression correlation between them.Conclusion Serum RBP4 may serve as the predictive factor of DN complicating SCI and is positively correlated with neurocognitive dysfunction.Lp-PLA2/CXCR4 pathway activation may be one of its pathogenesis.