血清Netrin-1、FGF22、miR-221水平与抑郁症患者认知功能损害的相关性分析

Correlation between serum levels of Netrin-1,FGF22,miR-221 and cognitive impairment in patients with depression

目的:分析血清神经轴突导向因子-1(Netrin-1)、成纤维细胞生长因子22(FGF22)、miR-221水平与抑郁症患者认知功能损害的相关性。方法:选取某院2021年6月—2023年7月收治的120例抑郁症患者为研究组,另选取同期120例健康体检者为对照组。采用智力状态检查量表(MMSE)评估患者认知功能,采用汉密尔顿抑郁量表(HAMD-24)评估患者抑郁程度;比较2组及不同认知状态患者入院时血清Netrin-1、FGF22、miR-221水平,另比较不同抑郁程度患者血清各指标水平及MMSE评分,并分析其相关性,ROC分析入院时血清Netrin-1、FGF22、miR-221联合检测对抑郁症患者认知功能障碍的诊断价值。结果:研究组血清Netrin-1、FGF22水平[(274.56±14.56)pg/mL、(157.46±21.47)ng/mL]低于对照组[(437.93±13.71)pg/mL、(217.56±20.66)ng/mL],血清miR-221水平(3.67±1.26)高于对照组(1.06±1.39),差异均有统计学意义(P<0.05);认知障碍患者血清Netrin-1、FGF22水平[(177.46±37.16)pg/mL、(131.71±21.47)ng/mL]低于认知正常患者[(330.78±36.44)pg/mL、(172.37±19.56)ng/mL],血清miR-221水平(4.14±1.14)高于认知正常患者(3.24±1.26),差异均有统计学意义(P<0.05);轻度抑郁患者血清Netrin-1、FGF22水平及MMSE评分均高于中度及重度抑郁患者,血清miR-221水平均低于中度及重度抑郁患者,差异均有统计学意义(P<0.05);血清Netrin-1、FGF22与MMSE评分呈正相关(r=0.694、0.677,P值均<0.001),miR-221与MMSE评分呈负相关(r=-0.715,P<0.001),差异有统计学意义(P<0.05);入院时血清Netrin-1、FGF22、miR-221水平诊断抑郁症患者发生认知功能障碍的AUC分别为0.749、0.814、0.766,三者联合检测AUC为0.926。结论:在抑郁症认知功能损害患者中血清Netrin-1、FGF22水平升高,miR-221水平降低,均与认知功能障碍密切相关,三者联合检测对抑郁症患者认知功能障碍具有较高的诊断价值。

Objective:To analyze the correlation between serum levels of Netrin-1,FGF22,miR-221 and cognitive impairment in patients with depression.Methods:120 patients with depression admitted to a hospital from June 2021 to July 2023 were chosen as the study objects,and another 120 healthy adults over the same period as controls.MMSE was used to appraise the patients'cognitive function and HAMD-24 was applied to judge the degree of the patients'depression.Serum levels of Netrin-1,FGF22,and miR-221 of the patients with different cognitive status in the two groups were compared.Serum indicators and MMSE scores of the patients with different degrees of depression were also compared and the correlation between them was observed.Diagnostic value of joint detection of Netrin-1,FGF22,and miR-221 on cognitive impairment of the patients with depression on admission was appraised with ROC.Results:Serum levels of Netrin-1 and FGF22[(274.56±14.56)pg/mL,(157.46±21.47)ng/mL]of the observation group were both lower than those of the control group[(437.93±13.71)pg/mL,(217.56±20.66)ng/mL],while serum level of miR-22(3.67±1.26)was higher than that of the control group(1.06±1.39),the differences being significant(P<0.05).Serum levels of Netrin-1 and FGF22 of the patients with cognitive impairment[(177.46±37.16)pg/mL,(131.71±21.47)ng/mL]were lower than those with normal cognition[(330.78±36.44)pg/mL,(172.37±19.56)ng/mL],while serum level of miR-22(4.14±1.14)was higher than that of the patients with normal cognition(3.24±1.26)(P<0.05).Serum levels of Netrin-1 and FGF22 and MMSE scores in the patients with mild depression were higher than those in patients with moderate or severe depression,while serum level of miR-221 were lower than those patients(P<0.05).Serum levels of Netrin-1 and FGF22 were positively correlated with MMSE scores(r=0.694,0.677,all P<0.001),while miR-221 was negatively correlated with MMSE scores(r=-0.715,P<0.001)(P<0.05).The AUC indicators used to diagnose cognitive impairment with serum levels of Netrin-1,FGF22 and miR-221were respectively 0.749,0.814,0.766,and AUC in the joint detection by the 3 indicators was 0.926.Conclusion:Serum levels of Netrin-1 and FGF22 remarkably increase in depression patients with cognitive impairment,while serum level of miR-221 remarkably decreases,which were all closely correlated with cognitive impairment.The joint detection by the 3 indicators is of high value for the diagnosis of cognitive impairment in patients with depression.