糖尿病合并阿尔茨海默病患者血清可溶性凋亡相关因子及其配体的表达及临床意义

Expression and clinical significance of serum sFas and sFasL in patients with diabetes mellitus and Alzheimer’s disease

目的 探讨糖尿病合并阿尔茨海默病(AD)患者血清可溶性凋亡相关因子(sFas)和sFasL配体(sFasL)表达及临床意义。方法 选取2020年5月至2021年12月鄂州市中心医院老年病科老年2型糖尿病(T2DM)患者130例,根据是否合并AD分为合并组65例和未合并组65例,另选取同期单纯AD患者65例作为单纯AD组,老年健康体检者65例为对照组。检测各组血清sFas、sFasL水平。结果 合并组血清sFas、sFasL水平高于单纯AD组、未合并组及对照组,单纯AD组血清sFas、sFasL水平高于未合并组及对照组,未合并组血清sFas、sFasL水平高于对照组(P<0.05);合并组痴呆重度患者血清sFas、sFasL水平高于中度患者及轻度患者,中度患者血清sFas、sFasL水平高于轻度患者(P<0.05);血清sFas、sFasL水平与T2DM患者临床痴呆评定量表评分呈正相关(r=0.773、r=0.689,P<0.01);血清sFas、sFasL联合检测诊断T2DM合并AD的ROC曲线下面积(AUC)为0.836(95%CI:0.761~0.895),明显高于血清sFas、sFasL单独诊断的AUC(P<0.05)。结论 T2DM合并AD患者血清sFas、sFasL水平升高,二者与痴呆程度有关,联合检测对T2DM合并AD具有良好的诊断价值。

Objective To explore the expression and clinical significance of serum sFas and sFasL in T2DM patients complicated with AD.Methods A total of 130 elderly T2DM patients in our department between May 2020 and December 2021 were recruited in this study.According to complication of AD or not, they were divided into T2DM combined with AD group(65 cases) and simple T2DM group(65 cases).Another 65 patients with only AD and 65 healthy individuals taking physical examination during the same period were enrolled as simple AD group and control group, respectively.The serum levels of sFas and sFasL were detected in all above groups.ResultsThe serum levels of sFas and sFasL were significantly higher in the T2DM combined with AD group than the simple AD group, simple T2DM group and control group(P<0.05),in the simple AD group than the simple T2DM group and control group(P<0.05),and in the simple T2DM group than the control group(P<0.05),and in the severe AD subgroup than the moderate and mild AD subgroups, and in the moderate AD subgroup than the mild AD subgroup(P<0.05).The serum levels of sFas and sFasL were positively correlated with CDR score in the T2DM patients(r=0.773,r=0.689,P<0.05).AUC of combined detection was 0.836(95%CI:0.761-0.895),greater than that of sFas and sFasL alone(P<0.05).Conclusion The serum levels of sFas and sFasL are increased in T2DM patients complicated with AD,and are related to the severity of dementia.The combined detection of them has good diagnostic value for T2DM combined with AD.