甲状腺功能正常桥本甲状腺炎患者血清ENO1Ab水平与轻度认知障碍的关联性分析

Analysis of the relationship between serum ENO1Ab level and mild cognitive impairment in Hashimoto's thyroiditis patients with normal thyroid function

目的分析甲状腺功能正常桥本甲状腺炎(HT)患者血清α-烯醇化酶抗体(ENO1Ab)水平与轻度认知障碍(MCI)的关联性。方法招募2022年2月至2023年2月徐州医科大学附属医院收治的甲状腺功能正常的HT患者98例,根据简易精神状态评估量表(MMSE)评分将其分为认知功能正常组(55例,27分≤MMSE评分≤30分)和MCI组(43例,21分≤MMSE评分<27分)。比较两组甲状腺功能指标及血清ENO1Ab水平,通过多因素logistic回归分析HT患者发生MCI的影响因素。采用受试者工作特征(ROC)曲线分析评价ENO1Ab对HT患者发生MCI的诊断效能。结果MCI组年龄、甲状腺过氧化物酶抗体(TPOAb)、ENO1Ab水平均高于认知功能正常组,受教育程度低于认知功能正常组,差异均有统计学意义(P<0.05)。相关性分析结果显示,MMSE评分与年龄、TPOAb、ENO1Ab呈负相关(P<0.05)。多因素logistic回归分析结果显示,较大的年龄,以及较高的TPOAb、ENO1Ab水平是促进HT患者发生MCI的独立危险因素(P<0.05)。ROC曲线分析结果显示,ENO1Ab具有诊断HT合并MCI的应用价值[AUC(95%CI)=0.745(0.648~0.843),P=0.001],其最佳截断值为9.455 ng/ml,对应的灵敏度为62.80%,特异度为76.40%。结论甲状腺功能正常HT患者MCI的发生风险与ENO1Ab水平呈正关联,应引起临床医师的关注。

Objective To investigate the relationship between serum alpha-enolase antibody(ENO1Ab)level and mild cognitive impairment(MCI)in Hashimoto's thyroiditis(HT)patients with normal thyroid function.Methods Ninety-eight HT patients with normal thyroid function who were admitted to the Affiliated Hospital of Xuzhou Medical University from February 2022 to February 2023 were recruited and divided into a normal cognitive function group(55 cases,27 points≤Mini-Mental State Examination(MMSE)scores≤30 points)and an MCI group(43 cases,21 points≤MMSE scores<27 points)according to the MMSE score.The thyroid function indexes and serum ENO1Ab levels were compared between the two groups.The influencing factors of MCI in the HT patients were analyzed by multivariate logistic regression.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic efficacy of ENO1Ab for MCI in the HT patients.Results The age,thyroid peroxidase antibody(TPOAb)and ENO1Ab levels in the MCI group were higher than those in the normal cognitive function group,and the education level in the MCI group was lower than that in the normal cognitive function group,and the differences were statistically significant(P<0.05).The results of correlation analysis showed that MMSE score was negatively correlated with age,TPOAb and ENO1Ab(P<0.05).The results of multivariate logistic regression analysis showed that older age and higher levels of TPOAb and ENO1Ab were independent risk factors for promoting MCI in the HT patients(P<0.05).The results of ROC curve analysis showed that ENO1Ab had application value in diagnosing HT complicated with MCI[AUC(95%CI)=0.745(0.648-0.843),P=0.001],and its optimal cut-off value was 9.455 ng/ml.The corresponding sensitivity and specificity were 62.80% and 76.40%,respectively.Conclusion The occurrence of MCI in the HT patients with normal thyroid function is positively correlated with ENO1Ab level,which should be paid attention to by clinicians.