血清8-iso-PGF2α、Irisin、FNDC5在血管性认知功能障碍患者中的表达及临床意义

Expression and clinical significance of serum 8-iso-PGF2α,Irisin and FNDC5 in patients with vascular cognitive impairment

目的 探讨血管性认知功能障碍(vascular cognitive impairment,VCI)患者血清8异构前列腺异素(8-iso-prostaglandin,8-iso-PGF2α)、鸢尾素(Irisin)、纤维连接蛋白Ⅲ型域包含蛋白5(fibronectin typeⅢdomain inclusion protein 5,FNDC5)表达及临床意义。方法 选取我院血管性认知功能障碍患者92例为观察组,同期选取健康体检者48例为对照组。比较2组血清8-iso-PGF2α、Irisin、FNDC5水平及蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)评分,分析VCI患者血清8-iso-PGF2α、Irisin、FNDC5水平与MoCA评分相关性,Logistic回归分析非痴呆性血管性认知功能障碍(vascular cognitive impairmentno dementia,VCIND)进展为血管性痴呆(vasculardementia,VD)的影响因素,受试者工作特征(receiver operating characteristic curve,ROC)曲线分析血清8-iso-PGF2α、Irisin、FNDC5对VCIND进展为VD的预测价值。结果 观察组血清8-iso-PGF2α水平高于对照组,血清Irisin、FNDC5水平及MoCA评分低于对照组(t=13.999、11.702、20.186、9.211,P<0.05);VCI患者血清8-iso-PGF2α水平与MoCA评分呈负相关,Irisin、FNDC5水平与MoCA评分呈正相关(r=-0.736、0.751、0.698,P<0.05);Logistic回归分析显示,血清8-iso-PGF2α升高及Irisin、FNDC5降低为VCIND进展为VD的独立危险因素(OR=4.999、0.362、0.387,P<0.05);ROC曲线显示,8-iso-PGF2α、Irisin、FNDC5对VCIND进展为VD均具有一定预测价值,且联合预测的AUC达0.866。结论 血清8-iso-PGF2α、Irisin、FNDC5均参与VCI发生发展,与患者认知功能损害程度密切相关,且可有效预测VCIND进展为VD的风险。

Objective To explore the expression and clinical significance of serum 8-iso-prostaglandin(8-iso-PGF2α),Irisin,and fibronectin typeⅢdomain-containing protein5(FNDC5)in patients with vascular cognitive impairment(VCI).Methods A total of 92 patients with VCI in our hospital were selected as the observation group,and 48 healthy physical examinees were selected as the control group during the same period.The serum 8-iso-PGF2α,Irisin,FNDC5 levels and montreal cognitive assessment(MoCA)scores of the two groups were compared,and the correlation of serum 8-iso-PGF2α,Irisin,and FNDC5 levels with MoCA scores in VCI patients was analyzed.Logistic regression analysis was used to analyze the factors influencing the progression of vascular cognitive impairment no dementia(VCIND)to vascular dementia(VD).Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 8-iso-PGF2α,Irisin,and FNDC5 in predicting VCIND progression to VD.Results The serum 8-iso-PGF2αlevel in the observation group was higher than that in the control group,while the serum Irisin,FNDC5 level and MoCA score were lower than those in the control group(t=13.999,11.702,20.186,9.211,P<0.05).The serum 8-iso-PGF2αlevel of VCI patients was negatively correlated with MoCA score,and the levels of Irisin and FNDC5 were positively correlated with MoCA score(r=-0.736,0.751,0.698,P<0.05).Logistic regression analysis showed that elevated serum 8-iso-PGF2αand decreased Irisin and FNDC5 were independent risk factors for VCIND progression to VD(OR=4.999,0.362,0.387,P<0.05).The ROC curve showed that 8-iso-PGF2α,Irisin and FNDC5 had certain predictive value for VCIND progression to VD,and the AUC of the joint prediction reached 0.866.Conclusion Serum 8-iso-PGF2α,Irisin and FNDC5 are all involved in the occurrence and development of VCI,which are closely related to the degree of cognitive impairment in patients,and can effectively predict the risk of progression from VCIND to VD.