血清HDAC3、CX3CL1水平与帕金森患者病情严重程度的关系

Relationship analysis of serum HDAC3,CX3CL1 levels with severity of Parkinson′s disease

目的探讨帕金森(PD)患者血清中组蛋白脱乙酰基酶3(HDAC3)、CX3趋化因子配体1(CX3CL1)与病情严重程度的关系。方法选取2020年9月至2023年9月在邯郸市中医院就诊的73例PD患者作为PD组,另选取同期在邯郸市中医院体检的77例健康者作为对照组。采用修订Hoehn-Yahr(H-Y)分期及帕金森统一评分量表第3部分(UPDRS-Ⅲ)评估PD患者的严重程度,并根据H-Y分期将PD患者分为早期组、中期组和晚期组;采用蒙特利尔认知评估量表(MoCA)评估PD患者的认知功能;采用酶联免疫吸附试验检测研究对象血清HDAC3、CX3CL1水平;绘制受试者工作特征(ROC)曲线分析HDAC3、CX3CL1对晚期PD的预测价值;采用多因素Logistic回归分析PD患者病情严重程度的影响因素;采用Spearman相关分析PD患者血清HDAC3、CX3CL1水平与UPDRS-Ⅲ、MoCA评分及病程的相关性。结果PD组患者血清HDAC3、CX3CL1水平显著高于对照组(P<0.05)。73例PD患者中,早期组27例,中期组25例,晚期组21例;不同PD分期组患者年龄、性别、体质量指数及有吸烟史、有饮酒史、合并高血压、合并糖尿病、合并高血脂病比例比较,差异均无统计学意义(P>0.05);MoCA评分为早期组>中期组>晚期组,且任意两组间比较,差异均有统计学意义(P<0.05);病程、UPDRS-Ⅲ评分及血清HDAC3、CX3CL1水平为早期组<中期组<晚期组,且任意两组间比较,差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,PD患者血清HDAC3、CX3CL1水平与UPDRS-Ⅲ评分和病程呈正相关(P<0.05),与MoCA评分呈负相关(P<0.05)。血清HDAC3、CX3CL1单独及联合预测晚期PD的曲线下面积分别为0.805(95%CI:0.682~0.929)、0.843(95%CI:0.736~0.950)、0.894(95%CI:0.849~0.997),灵敏度分别为71.43%、66.67%、80.95%;多因素Logistic回归分析结果显示,血清HDAC3、CX3CL1升高是PD患者病情进展至晚期的危险因素(P<0.05)。结论PD患者血清HDAC3、CX3CL1水平升高与PD患者病情严重程度密切相关,且对病情严重程度有一定的诊断价值。

Objective To investigate the relationship of serum histone deacetylase 3(HDAC3)and CX3 chemokine ligand 1(CX3CL1)levels in Parkinson′s disease(PD)patients with the severity of the disease.Methods Seventy-three PD patients who attended Handan Traditional Chinese Medicine Hospital from September 2020 to September 2023 were selected as the PD group,and 77 healthy individuals who underwent physical examination in Handan Traditional Chinese Medicine Hospital during the same period were selected as the control group.The severity of PD patients was assessed by the Revised Hoehn-Yahr(H-Y)classification and the Unified Parkinson′s Rating Scale Part 3(UPDRS-Ⅲ),and the PD patients were divided into early stage group,middle stage group and late stage group according to H-Y classification;the cognitive function of PD patients was assessed by the Montreal Cognitive Assessment Scale(MoCA);the enzyme-linked immunosorbent assay was used to detect serum HDAC3,CX3CL1 levels of all subjects;receiver operating characteristic curves were applied to analyze the predictive value of serum HDAC3 and CX3CL1 on the late stage of PD;multivariate Logistic regression was applied to analyze the factors affecting the severity of PD;Spearman′s correlation was applied to analyze the correlation of serum HDAC3,CX3CL1 levels with UPDRS-Ⅲ,MoCA scores and disease duration in PD patients.Results Serum HDAC3 and CX3CL1 levels in the PD group were significantly higher than those in the control group(P<0.05).Among 73 PD patients,27 cases were in the early stage group,25 cases in the middle stage group and 21 cases in the late stage group;there were no statistically obvious differences in age,gender,body mass index and proportions of patients with smoking history,drinking history,hypertension,diabetes millitus and hyperlipidemia among three PD stage groups(P>0.05);the MoCA score of patients in the early stage group>the middle stage group>the late stage group,and comparisons between any two groups showed statistically significant differences(P<0.05);disease duration,UPDRS-Ⅲscore and serum HDAC3,CX3CL1 levels of patients in the early stage group<middle stage group<late stage group,and comparisons between any two groups showed statistically significant differences(P<0.05).Pearson′s correlation analysis results showed that the serum levels of HDAC3 and CX3CL1 in PD patients were positively correlated with UPDRSⅢscore and disease duration(P<0.05),but negatively correlated with MoCA score(P<0.05);The area under the curves of serum HDAC3 and CX3CL1,alone or in combination,for predicting late stage of PD was 0.805(95%CI:0.682-0.929),0.843(95%CI:0.736-0.950)and 0.894(95%CI:0.849-0.997),respectively,with sensitivity of 71.43%,66.67%and 80.95%,respectively;multivariate Logistic regression results showed that elevated levels of serum HDAC3 and CX3CL1 were risk factors for the late stage of PD patients(P<0.05).Conclusion The elevated levels of serum HDAC3 and CX3CL1 in PD patients are closely related to the severity of PD,and the above two indicators have a certain diagnostic value for the assessment of disease severity.