可溶性低密度脂蛋白受体相关蛋白1在阿尔茨海默病血清中的表达及临床意义

Expression change and clinical significance of soluble low-density lipoprotein receptor-related protein 1 in patients with Alzheimer’s disease

目的通过检测阿尔茨海默病(AD)病人血清中可溶性低密度脂蛋白受体相关蛋白1(sLRP-1)的表达水平,分析其与AD病人临床指标之间的关系,解析其在AD诊断中的临床意义。方法选择2016年7月至2020年2月在资阳市第一人民医院确诊的AD病人82例为AD组,同时选择在资阳市第一人民医院进行体检的健康者95例为对照组,采用酶联免疫吸附实验(ELISA)法对所有受试者血清中sLRP-1、β淀粉样蛋白1-42(Amyloid-beta 1-42,Aβ1-42)水平进行测定、用全自动生化分析仪对血清中总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)含量进行测定,分析AD病人血清中sLRP-1表达水平与临床病理各项指标的相关性,受试者操作特征曲线(ROC)分析血清sLRP-1表达水平对AD的诊断价值。结果AD病人ADAS-cog评分高于对照组[(18.90±5.06)分比(5.52±2.38)分,P<0.05],血清中HDL-C水平[(1.27±0.29)mmol/L比(1.43±0.22)mmol/L]、ADL评分[(70.92±23.13)分比(98.87±23.73)分]、MMSE评分[(24.03±5.17)分比(28.73±7.37)分]均低于对照组(P<0.05);AD组病人血清sLRP-1表达水平显著低于对照组[(11.16±3.63)mg/L比(17.84±5.31)mg/L,P<0.05],血清中Aβ1-42浓度显著高于对照组[(53.34±16.07)μg/L比(38.31±10.77)μg/L],随着痴呆程度的加深,AD病人血清中sLRP-1表达水平呈依次降低趋势(P<0.05),血清中Aβ1-42浓度呈现依次升高趋势(P<0.05);Pearson相关性分析表明AD病人血清中sLRP-1表达水平与血清中Aβ1-42浓度、ADAS-cog评分呈负相关(P<0.05),与血清中HDL-C水平、ADL评分、MMSE评分呈正相关(P<0.05);ROC曲线结果表明,血清sLRP-1表达水平诊断AD曲线下面积(AUC)为0.84,95%CI为(0.77,0.90,),敏感度为82.1%,特异性为84.1%,截断值为13.943 mg/L。结论血清sLRP-1表达水平变化与AD密切相关,ROC曲线分析表明血清sLRP-1表达水平对AD具有一定诊断价值。

Objective To detect the expression level of soluble low-density lipoprotein receptor-related protein 1(sLRP-1)in serum of patients with Alzheimer’s disease(AD),analyze the relationship between s LRP-1 and clinical indicators of AD patients,and analyze its clinical significance in the diagnosis of AD.Methods Eighty-two cases of AD patients diagnosed in Ziyang First People’s Hospital from July 2016 to February 2020 were selected as AD group,and 95 healthy people who had physical examination in Ziyang First People’s Hospital were selected as control group.The levels of serum s LRP-1 and amyloidβ1-42(Aβ1-42)were measured by enzymelinked immunosorbent assay(ELISA),the contents of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)in serum were determined by automatic biochemical analyzer,the correlation between s LRP-1 expression and clinicopathological parameters was analyzed,and receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of serum s LRP-1 in AD.Results The ADAS-cog score of AD patients was higher than that of the control group[(18.90±5.06)vs.(5.52±2.38),P<0.05],and the serum HDL-C level[(1.27±0.29)mmol/L vs.(1.43±0.22)mmol/L],ADL score[(70.92±23.13)vs.(98.87±23.73)]and MMSE score[(24.03±5.17)vs.(28.73±7.37)]were lower than those of the control group(P<0.05);the expression level of serum s LRP-1 in AD group was significantly lower than that in control group[(11.16±3.63)mg/L vs.(17.84±5.31)mg/L,P<0.05],and serum Aβ1-42 concentration was significantly higher than that in control group[(53.34±16.07)μg/L vs.(38.31±10.77)μg/L],with the deepening of dementia,the expression level of s LRP-1 in serum of AD patients decreased in turn(P<0.05),and the concentration of serum Aβ1-42 increased in turn(P<0.05);Pearson correlation analysis showed that the expression level of s LRP-1was negatively correlated with Aβ1-42 concentration and ADAS-cog score(P<0.05),but positively correlated with HDL-C level,ADL score and MMSE score(P<0.05);ROC curve showed that the area under curve(AUC)of serum s LRP-1 in the diagnosis of AD was 0.84,95%CI(0.77,0.90),sensitivity was 82.1%,specificity was 84.1%,cut-off value was 13.943 mg/L.Conclusion The change of serum s LRP-1 expression level is closely related to AD.ROC curve analysis shows that serum s LRP-1 expression level has certain diagnostic value for AD.