轻度认知障碍及主观认知下降患者血清胱抑素C与认知的相关性研究

Correlation Between Serum Cystatin C and Cognition in Patients with Mild Cognitive Impairment and Subjective Cognitive Decline

目的探讨血清胱抑素C(cystatin C,CysC)水平与轻度认知障碍(mild cognitive impairment,MCI)及主观认知下降(subjective cognitive decline,SCD)患者认知的相关性。方法选取2020-01/2022-03月作者医院MCI患者50例(MCI组)、SCD患者49例(SCD组)及正常中老年人50例(对照组)为研究对象。比较3组研究对象血清CysC水平差异。通过蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)测定3组研究对象的认知功能。利用单因素分析以及多因素Logistic回归分析对研究对象血清CysC及相关指标进行分析。采用受试者工作特征(receiver operating characteristic,ROC)曲线评价血清CysC对认知障碍的评估价值。采用Pearson相关分析评估血清CysC与整体认知功能及各个不同认知域的关系。结果经单因素分析结果显示,各组间血清CysC、超氧化物歧化酶(superoxide dismutase,SOD)、β_(2)微球蛋白(β_(2)-microglobulin,β_(2)M)水平比较差异具有统计学意义(P<0.05)。多因素Logistic回归分析发现,血清CysC的水平是认知障碍的独立危险因素(P<0.05)。ROC曲线分析显示,血清CysC>0.875 mg/L时,患者发生MCI、SCD的风险增高。Pearson相关分析结果表明,血清CysC与整体认知功能MoCA总分呈负相关(r=-0.318,P<0.01),且在视空间与执行功能、语言、延迟回忆项目上也呈负相关(r=-0.213、-0.169、-0.234,P均<0.05)。结论血清CysC水平与MCI及SCD患者的认知功能存在负相关,通过监测血清CysC指标,对疾病早期的预测有一定价值。

Objective To explore the correlation between serum cystatin C(CysC)level and cognition of patients with mild cognitive impairment(MCI)and subjective cognitive decline(SCD).Methods A total of 50 cases of MCI patients(MCI group),49 cases of SCD patients(SCD group)and 50 cases of normal middle-aged or elderly people(control group)were selected from author′s hospital from January 2020 to March 2022.The differences of serum CysC levels among the three groups were compared.The cognitive function of the three groups of objects was measured by Montreal cognitive assessment(MoCA).The serum CysC and related indicators of objects were analyzed by univariate analysis and multivariate Logistic regression analysis.The value of serum CysC in the evaluation of cognitive impairment was evaluated by receiver operating characteristic(ROC)curve.The relationship between serum CysC and global cognitive function and different cognitive domains was evaluated by Pearson correlation analysis.Results The results of univariate analysis showed that there were statistically significant differences in serum CysC,superoxide dismutase(SOD)andβ_2-microglobulin(β_2M)levels among the groups(P<0.05).Multivariate Logistic regression analysis showed that the CysC level was an independent risk factor for cognitive impairment(P<0.05).ROC curve analysis showed that the risk of MCI and SCD increased when serum CysC0.875 mg/L.Pearson correlation analysis showed that serum CysC was negatively correlated with overall cognitive function MoCA(r=-0.318,P<0.01),and was also negatively correlated with visuospatial and executive function,language and delayed recall(r=-0.213,-0.169,-0.234,all P<0.05).Conclusion There is a negative correlation between serum CysC level and cognitive function in patients with MCI and SCD,and it has certain value in the early prediction of the disease by monitoring serum CysC indicators.