社区老年人群痴呆早期筛查和预测的生物指标研究

Study on biological indexes for early screening and prediction of dementia in the community elderly

目的初步探索老年人群痴呆早期筛查的生化指标与易感基因,为早期诊断提供证据。方法采用随机整群抽样方法选取石家庄3个社区年龄≥60岁的老年人,采用统一问卷调查量表收集被调查者的人口学资料、蒙特利尔认知评估量表(MoCA)评分,并检测其血生化和炎性反应指标,采用MassArray法检测受试者46个阿尔茨海默病(AD)易感基因位点。根据MoCA结果将被调查者分为认知正常组、轻度认知障碍(MCI)组和痴呆组,比较各组生化指标、炎性反应指标以及易感基因分布的差异。结果与认知正常组相比,MCI组血糖(Glu)、载脂蛋白B(ApoB)、载脂蛋白E(ApoE)升高(P<0.05),高密度脂蛋白(HDL)、载脂蛋白A-1(ApoA-1)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)显著降低(P<0.05或P<0.01);与认知正常组相比,痴呆组Glu、ApoB、ApoE、C反应蛋白(CRP)显著升高(P<0.05或P<0.01),ApoA-1、IL-6、TNF-α显著降低(P<0.01)。MCI组与认知正常组相比较在FADS1、FADS2、ABCA7、ELOVL2、PICALM、MYRF、MS4A4A、MS4A6A等基因上具有统计学差异,痴呆组与认知正常组相比较在MS4A4A、MS4A6A等基因上具有统计学差异。结论Glu、HDL、ApoA-1、ApoB、ApoE、IL-6、TNF-α等生化指标和FADS1、FADS2、ABCA7、ELOVL2、PICALM、MYRF、MS4A4A、MS4A6A等基因在早期筛查MCI和痴呆中可能具有重要意义。

Objective To explore early screening biochemical indicators and susceptibility genes for dementia in elderly people and provide evidence for early diagnosis.Methods A random cluster sampling method was adopted to select elderly persons aged>60 years in three communities of Shijiazhuang.A questionnaire was used to collect the demographic data of the respondents and the scores of Montreal Cognitive Assessment(MoCA)scale were assessed.And the biochemical and inflammatory indexes were detected through the participants/blood.The MassArray method was used to detect 46 susceptibility loci ofAlzheimer’s disease.The subjects were divided into a control group,a mild cognitive impairment(MCI)group and a dementia group by MoCA results.Biochemical,inflammatory and susceptibility gene distributions were separately analyzed between the normal group and the other two groups.Results Compared with the normal group?the biochemical indices of the MCI group were significantly elevated in glucose(Glu),apolipoprotein B(ApoB),and apolipoprotein E(ApoE)(all A<0.05),while high density lipoprotein(HDL),apolipoprotein a1(ApoA-1),interleukin-6(IL-6),and tumor necrosis factor a(TNF-a)were significantly decreased(P<0.05 or P<0.01).Between the dementia group and the normal group,the dementia group had a significant increase in Glu,ApoB,ApoE and C-reactionprotein(CRP)(P<0.05 or P<0.01).On the contrary,the dementia group had a significant reduce in ApoA-1,IL-6 and TNF-a(P<0.01).There were significant differences between the MCI group and the normal cognition group in the genes such as FADS1,FADS2,AABCA7,ELOVL2,PICALM,MYRF,MS4A4A,MS4A6A,and between the dementia group and the normal cognition group:the MS4A4A and MS4A6A genes.Conclusions Glu,HDL ApoA-1,ApoB,ApoE,IL-6,TNF-a and other biochemical indicators and FADS1,FADS2,ABCA7,ELOVL2,PICALM,MYRF,MS4A4A,MS4A6A gene are valuable in the community elderly for early screening for MCI and dementia.