外周血Klotho蛋白和mRNA对老年AD和MCI患者认知功能障碍的预测价值研究

The predictive value of Klotho protein and mRNA in peripheral blood on cognitive dysfunction in elderly patients with AD and MCI

目的探究外周血Klotho蛋白和mRNA对老年阿尔茨海默病(AD)和轻度认知功能障碍(MCI)患者认知功能障碍的预测价值。方法选取2021年2月至2022年4月新疆医科大学第一附属医院老年病科收治的160例患者为研究对象,其中AD组40例,MCI组40例,对照组80例。使用ELISA和qRT-PCR检测三组的Klotho蛋白和mRNA表达。分析Klotho蛋白和mRNA表达在三组人群中的差异。多因素Logistic回归分析AD、MCI患者患病相关影响因素。受试者工作特征(ROC)曲线分析外周血Klotho蛋白和mRNA对老年认知功能障碍的预测价值。结果AD组、MCI组Klotho mRNA表达均低于对照组(P<0.05),MCI组Klotho蛋白表达低于对照组(P<0.05)。年龄和Klotho mRNA是AD的影响因素(OR=1.077、0.366,P<0.05)。Klotho蛋白和Klotho mRNA是MCI的影响因素(OR=0.598、0.110,P<0.05)。ROC曲线显示,Klotho蛋白、Klotho mRNA及两项指标联合预测AD、MCI和认知功能障碍的曲线下面积分别为0.598、0.717、0.731;0.627、0.764、0.812;0.612、0.741、0.771,可见Klotho蛋白和mRNA联合预测效果优于单项指标。结论Klotho mRNA低表达与AD和MCI相关。Klotho蛋白低表达与MCI相关,与AD不相关。年龄是AD的独立危险因素,Klotho mRNA是AD和MCI的保护因素、Klotho蛋白是MCI保护因素,Klotho蛋白和mRNA联合预测对老年认知功能障碍的预测效能最佳。

Objective To explore the predictive value of Klotho protein and mRNA in peripheral blood for cognitive dysfunction in elderly patients with Alzheimer disease(AD) and mild cognitive impairment(MCI).Methods A total of 160 patients,admitted to the Department of Geriatrics of the First Affiliated Hospital of Xinjiang Medical University from February 2021 to April 2022,were selected as the study objects,including 40 cases in the AD group,40 cases in the MCI group,and 80 cases in the control group.This study mainly detected the expression of Klotho protein and mRNA in the three groups with the help of ELISA and qRT-PCR,analyzed the differnces in the expression of Klotho protein and mRNA in the three groups,and used the multiple Logistic regression to observe the disease-related influencing factors in AD and MCI patients.Furthermore,through the curve of receiver operating characteristic(ROC),the predictive value of Klotho protein and mRNA in peripheral blood for cognitive impairment in old age could be achieved.Results The expression of Klotho mRNA in AD Group and MCI Group and the expression of Klotho protein in MCI Group were lower than those in Control Group(P <0.05),age and Klotho mRNA were the influencing factors of AD(OR=1.077,0.366,P <0.05),and Klotho protein and Klotho mRNA were the affecting factors of MCI(OR=0.598,0.110,P <0.05).Moreover,the ROC curve showed that the area under the curve of Klotho protein,Klotho mRNA and the combination of the two indexes for predicting AD,MCI and cognitive impairment were 0.598,0.717,0.731,and 0.627,0.764,0.812,and 0.612,0.741,0.771,respectively,indicating that the combined prediction effect of Klotho protein and mRNA was better than the single index.Conclusion Low expression of Klotho mRNA was associated with AD and MCI,while low expression of Klotho protein was correlated with MCI not AD.In addition,age was an independent risk factor for AD,Klotho mRNA was a protective factor for AD and MCI,and Klotho protein was a protective factor for MCI,and the combination of Klotho protein and mRNA was the best predictor of cognitive dysfunction in the elderly.