双相障碍患者炎症因子和胶质细胞源性神经营养因子与认知功能的关系

Relationships of cognitive function with inflammatory factors and glial cell line-derived neurotrophic factor in patients with bipolar disorders

目的计算中性粒细胞-淋巴细胞比(NLR)和血小板-淋巴细胞比(PLR),检测胶质细胞源性神经营养因子(GDNF)的浓度,探讨其对双相障碍患者认知功能的影响。方法纳入双相障碍患者55例和健康对照者54例为研究对象,测量受试者的NLR、PLR和GDNF。采用言语流畅性测验(VFT)、连线测线(TMT)和Stroop试验评估患者的认知功能。结果观察组的NLR和PLR均比对照组高,而GDNF浓度降低(P<0.01)。观察组NLR和GDNF均与VFT-动作(r=-0.379,P=0.004;r=0.269,P=0.047)及TMT-B(r=0.597,P<0.001;r=-0.407,P=0.002)存在相关性。NLR与GDNF呈显著负相关(r=-0.415,P=0.002)。采用分层回归校正混杂因素后,NLR(β=15.475,P<0.001)、GDNF(β=-0.016,P=0.046)可以预测TMT-B的表现,其中NLR和GDNF交互项(β=0.166,P<0.001)可以正向预测认知功能(R^(2)=0.914),这表明两者的交互作用可以解释认知功能TMT-B总变异的30.5%。结论炎症因子、神经营养因子及其交互作用与认知功能密切相关。未来需要更大样本量的前瞻性研究以探索炎症因子和GDNF对认知功能的作用。

Objective To calculate the neutrophil-to-lymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR),detect the concentration of glial cell line-derived neurotrophic factor(GDNF),and investigate their effects on cognitive function in patients with bipolar disorders.Methods A total of 55 patients with bipolar disorders and 54 healthy controls were selected as research objects,and their NLR,PLR and GDNF were measured.Cognitive function of the patients was evaluated by verbal fluency test(VFT),trail-making test(TMT)and Stroop test.Results The NLR and PLR of the observation group were significantly higher than those of the control group,while the GDNF was significantly lower(P<0.01).In the observation group,NLR and GDNF were correlated with VFT-action(r=-0.379,P=0.004;r=0.269,P=0.047)and TMT-B(r=0.597,P<0.001;r=-0.407,P=0.002).NLR was significantly negatively correlated with GDNF(r=-0.415,P=0.002).After adjusting for confounding factors by hierarchical regression,NLR(β=15.475,P<0.001)and GDNF(β=-0.016,P=0.046)were able to predict performance of TMT-B,in which interactive items of NLR and GDNF(β=0.166,P<0.001)were able to positively predict cognitive function(R^(2)=0.914),and the result indicated that the interaction between the two indexes can explain 30.5%of the total variation of TMT-B in cognitive function.Conclusion Inflammation factors,neurotrophic factor and their interactions are closely related to cognitive function.A larger sample size prospective study is needed in the future to explore the effects of inflammation factors and GDNF on cognitive function.