阿尔茨海默症患者血清miR-211和miR-202表达水平及其与认知功能、焦虑抑郁情绪的相关性研究

Serum miR-211 and miR-202 Expression Levels in Alzheimer’s Disease Patients and Their Correlation with Cognitive Function,Anxiety and Depression

目的分析阿尔茨海默症(Alzheimer’s disease)患者血清微小核糖核酸(microRNA,miR)-211和miR-202表达水平及与认知功能、焦虑抑郁情绪的相关性研究。方法选取2019年3月~2022年3月河北燕达医院收治的阿尔茨海默症患者90例作为研究组,根据临床痴呆评定量表(clinical dementia rating,CDR)评分将患者分为轻度组(n=24)、中度组(n=48)和重度组(n=18)。另选取同期健康体检者90例作为对照组,比较血清miR-211和miR-202表达水平。Pearson法和Spearman法分析血清miR-211,miR-202以及二者与认知功能、焦虑抑郁情绪的相关性,采用Logistic回归分析阿尔茨海默症的影响因素。结果与对照组比较,研究组血清miR-211(0.59±0.16 vs 1.01±0.31)、miR-202(0.35±0.10 vs 1.00±0.32)表达水平降低,差异具有统计学意义(t=11.422,18.393,均P<0.05)。轻度、中度和重度组血清miR-211(0.73±0.21,0.62±0.17,0.32±0.08)表达水平、miR-202(0.51±0.15,0.33±0.10,0.19±0.04)表达水平、简易精神状态检查量表(mini-mental state examination,MMSE)评分(22.54±1.41分,19.35±1.01分,16.23±1.00分)和蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)评分(25.35±2.60分,18.59±1.32分,16.59±1.24分)逐渐降低,差异具有统计学意义(F=32.006,46.917,163.048,163.703,均P<0.05)。与轻度组比较,重度组、中度组血清miR-211,miR-202,MMSE和MoCA评分降低,差异具有统计学意义(t=3.685~25.375,均P<0.05)。轻度、中度和重度组Hamilton焦虑量表(hamilton anxiety scale,HAMA)评分(12.34±1.27分,20.59±2.09分,31.29±2.19分)和Hamilton抑郁量表(hamilton depression scale,HAMD)评分(14.35±2.13分,23.89±2.20分,35.35±1.21分)逐渐升高,差异具有统计学意义(F=496.059,553.939,均P<0.05)。根据Pearson相关性分析得知,miR-211与miR-202呈正相关(r=0.615,P<0.05)。根据Spearman相关性分析得知,miR-211和miR-202与MMSE和MoCA呈显著正相关(r=0.539~0.585,均P<0.05);与HAMA和HAMD呈显著负相关(r=-0.651~-0.539,均P<0.05)。根据Logistic回归分析得知miR-211[OR(95%CI):5.321(1.648~17.180)]和miR-202[OR(95%CI):3.158(1.989~5.012)]低表达是影响阿尔茨海默症的危险因素(均P<0.05)。结论阿尔茨海默症患者血清miR-211和miR-202表达水平降低,且miR-211和miR-202与认知功能、焦虑抑郁情绪密切相关。

Objective To analyze the expression levels of serum microRNA(miR)-211 and miR-202 in patients with Alzheimer’s disease and their correlation with cognitive function,anxiety and depression.Methods A total of 90 patients with Alzheimer’s disease admitted to Hebei Yanda Hospital from March 2019 to March 2022 were selected as the research group.According to the Clinical Dementia Rating(CDR)score,the patients were grouped into mild group(n=24),moderate group(n=48)and severe group(n=18).Another 90 healthy individuals who underwent physical examination were collected as the control group.The expression levels of miR-211 and miR-202 in serum were compared.Pearson method and Spearman method were used to analyze serum miR-211 and miR-202 and their correlation with cognitive function,anxiety and depression.Logistic regression analysis was used to analyze the influencing factors of Alzheimer’s disease.Results The expression levels of serum miR-211(0.59±0.16,1.01±0.31)and miR-202(0.35±0.10,1.00±0.32)were significantly reduced in the research group and control group,with significant differences(t=11.422,18.393,all P<0.05).Serum miR-211(0.73±0.21,0.62±0.17,0.32±0.08)expression levels,miR-202(0.51±0.15,0.33±0.10,0.19±0.04)expression levels,mini-mental state examination(MMSE)score(22.54±1.41 score,19.35±1.01 score,16.23±1.00 score)and Montreal cognitive assessment(MoCA)score(25.35±2.60 score,18.59±1.32 score,16.59±1.24 score)in the mild,moderate and severe groups gradually decreased,and the differences were statistically significant(F=32.006,46.917,163.048,163.703,all P<0.05).Compared with mild group,the serum miR-211,miR-202,MMSE and MoCA scores of severe group and moderate group were reduced,and the differences were statistically significant(t=3.685~25.375,all P<0.05).The mild,moderate and severe groups had a gradual increase in Hamilton anxiety scale(HAMA)score(12.34±1.27 score,20.59±2.09 score and 31.29±2.19 score)and Hamilton depression scale(HAMD)score(14.35±2.13 score,23.89±2.20 score and 35.35±1.21 score),and the differences were statistically significant(F=496.059,553.939,all P<0.05).According to Pearson correlation analysis,miR-211 was positively correlated with miR-202(r=0.651,P<0.05).According to Spearman correlation analysis,miR-211 and miR-202 were positively correlated with MMSE and MoCA(r=0.539~0.585,all P<0.05)and negatively correlated with HAMA and HAMD(r=-0.651~-0.539,all P<0.05).Logistic regression analysis showed that the low expression of miR-211[OR(95%CI):5.321(1.648~17.180)]and miR-202[OR(95%CI):3.158(1.989~5.012)]were risk factors for Alzheimer’s disease(P<0.05).Conclusion The serum expression levels of miR-211 and miR-202 in patients with Alzheimer’s disease were reduced,indicating miR-211 and miR-202 were closely related to cognitive function,anxiety and depression.