帕金森病伴2型糖尿病患者认知障碍程度与血清Hcy、BDNF、胃饥饿素及肥胖抑制素水平的关系

Relationship between cognitive impairment and serum Hcy, BDNF, Ghrelin and Obestatin levels in patients with Parkinson's disease and type 2 diabetes mellitus

目的探究帕金森病伴2型糖尿病(T2DM)患者认知障碍程度与血清同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)、胃饥饿素及肥胖抑制素水平的关系。方法回顾性选取2020年6月至2022年6月滨州医学院烟台附属医院收治的帕金森病伴T2DM患者85例(帕金森病伴T2DM组)和同期健康体检者60例(对照组)为研究对象,根据认知障碍程度将帕金森病伴T2DM组分为正常组(认知正常)44例、轻度组(轻度认知障碍)24例和痴呆组(痴呆)17例。比较各组血清Hcy、BDNF、胃饥饿素、肥胖抑制素水平,分析血清Hcy、BDNF、胃饥饿素、肥胖抑制素水平与帕金森病伴T2DM患者认知障碍程度的相关性,采用受试者工作特征(ROC)曲线评价上述指标对帕金森病伴T2DM患者认知障碍的预测价值。结果帕金森病伴T2DM组MoCA评分和血清BDNF、胃饥饿素、肥胖抑制素水平低于对照组,血清Hcy水平高于对照组,差异均有统计学意义(P<0.05)。正常组MoCA评分和血清BDNF、胃饥饿素、肥胖抑制素水平高于轻度组和痴呆组,血清Hcy水平低于轻度组和痴呆组,差异均有统计学意义(P<0.05);轻度组MoCA评分和血清BDNF、胃饥饿素、肥胖抑制素水平高于痴呆组,血清Hcy水平低于痴呆组,差异均有统计学意义(P<0.05)。Spearman相关性分析显示,帕金森病伴T2DM患者认知障碍程度与血清Hcy水平呈正相关(P<0.05),与血清BDNF、胃饥饿素、肥胖抑制素水平呈负相关(P<0.05)。ROC曲线分析显示,血清Hcy、BDNF、胃饥饿素、肥胖抑制素水平对帕金森病伴T2DM患者认知障碍均有一定预测效能,曲线下面积分别为0.873、0.884、0.780和0.773。结论血清Hcy、BDNF、胃饥饿素、肥胖抑制素水平均参与帕金森病伴T2DM患者认知障碍的发生及发展,有望成为预测认知障碍发生的生物标志物。

Objective To investigate the relationship between the degree of cognitive impairment and serum homocysteine(Hcy),brain-derived neurotrophic factor(BDNF),Ghrelin and Obestatin levels in patients with Parkinson's disease and type 2 diabetes mellitus(T2DM).Methods A total of 85 Parkinson's disease patients with T2DM admitted to Yantai Affiliated Hospital of Binzhou Medical College from June 2020 to June 2022(Parkinson's disease with T2DM group)and 60 healthy subjects(control group)were retrospectively selected as the research objects,according to the degree of cognitive impairment,the Parkinson's disease with T2DM group was divided into normal group(44 cases of cognitive impairment),mild group(24 cases of mild cognitive impairment)and dementia group(17 cases of dementia).The serum levels of Hcy,BDNF,Ghrelin and Obestatin in each group were compared,and the correlation between serum levels of Hcy,BDNF,Ghrelin and Obestatin and the degree of cognitive impairment in Parkinson's disease patients with T2DM was analyzed.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of the above indexes for cognitive impairment in Parkinson's disease patients with T2DM.Results The MoCA score and serum BDNF,Ghrelin and Obestatin levels in Parkinson's disease and T2DM group were lower than those in control group,and the serum Hcy level was higher than that in control group(P<0.05).The MoCA score and serum BDNF,Ghrelin,Obestatin levels in normal group were higher than those in mild group and dementia group(P<0.05),and the serum Hcy level was lower than that in mild group and dementia group(P<0.05);the MoCA score and serum BDNF,Ghrelin and Obestatin levels in the mild group were higher than those in the dementia group(P<0.05),and the serum Hcy level was lower than that in the dementia group(P<0.05).Spearman correlation analysis showed that the degree of cognitive impairment in Parkinson's disease patients with T2DM was positively correlated with serum Hcy level(P<0.05),and negatively correlated with serum BDNF,Ghrelin and Obestatin levels(P<0.05).ROC curve analysis showed that serum Hcy,BDNF,Ghrelin and Obestatin levels had certain predictive efficacy for cognitive impairment in Parkinson's disease patients with T2DM,and the areas under the curve were 0.873,0.884,0.780 and 0.773,respectively.Conclusion Serum levels of Hcy,BDNF,Ghrelin and Obestatin are involved in the occurrence and development of cognitive impairment in Parkinson's disease patients with T2DM,which is expected to be a biomarker for predicting the occurrence of cognitive impairment.