慢性炎症及端粒长度与阿尔茨海默病病人认知功能的相关性研究

Correlation between chronic inflammation,telomere length and cognitive function in patients with Alzheimer′s disease

目的探讨炎症指标hs-CRP及端粒长度(TL)与AD病人认知功能的相关性,比较不同TL下认知量表各认知域损害特点。方法选择老年病人共135例,分为正常对照组(NC组,n=49)和AD组(n=86),采集人口学及一般临床资料,抽取静脉血检测hs-CRP水平,提取外周血白细胞DNA测定TL,对入组人群评估MoCA评分。比较2组hs-CRP、TL、认知功能等方面的差异,并进一步将AD组按照TL三分位数进行分组,分析各亚组认知域之间的差异。结果AD组TL短于NC组(P<0.01),而hs-CRP水平高于NC组(P<0.05)。2组年龄、教育年限、DBP、HbA1c、Hcy、MoCA评分差异有统计学意义。Logistic回归分析显示hs-CRP、血Hcy、TL缩短是AD的独立危险因素。AD病人中短端粒组较长端粒组在视空间与执行力、注意力、计算能力、抽象和记忆力方面的认知损害更明显。结论慢性炎症、TL缩短是AD的可能危险因素,TL与认知域损害可能存在线性关系。

Objective To investigate the relationship of high-sensitivity C-reactive protein(hs-CRP)and telomere length(TL)with cognitive function in the patients with Alzheimer′s disease(AD),and to investigated the characteristics of cognitive impairment in the patients with different TL.Methods A total of 135 elderly patients were involved and divided into normal control group(NC group,n=49)and AD group(n=86).Demographic and general clinical data were collected.Venous blood was extracted to measure hs-CRP,and peripheral blood leukocyte DNA was extracted to measure TL.The score of Montreal Cognitive Assessment(MoCA)was used to evaluate the level of cognitive function.The levels of hs-CRP and TL were compared between the two groups.The AD patients were further categoried into three subgroups by TL,and the MoCA scores were compared between the subgroups.Results The level of TL in AD group was significantly shorter than that in NC group(P<0.01),while the level of hs-CRP was higher(P<0.05).Binary Logistic regression analysis showed that hs-CRP,serum homocysteine and shortening TL were the independent risk factors for AD.In the AD group,the patients with short telomere presented with more serious cognitive impairment in visual space,executive ability,attention,calculation ability,abstraction and memory compared with the patients with long telomere.Conclusions TL shows linear correlation with cognitive dysfunction in AD patients.