血清晚期糖基化终末产物和可溶性晚期糖基化终末产物受体与阿尔茨海默病及血管性痴呆关系的研究

Association of serum advanced glycation end products and soluble receptor for advanced glycation end products with Alzheimer's disease and vascular dementia

摘要:

目的 探讨血清中晚期糖基化终末产物（AGEs）、可溶性晚期糖基化终末产物受体（sRAGE）的水平与阿尔茨海默病（AD）、血管性痴呆（VaD）的关系。方法 收集兰州大学第二医院神经内科2017年2月到2018年1月收治的149例患者，根据MMSE量表及相应的纳入排除标准，将患者进行分组，其中AD组34例，脑梗死后痴呆（VaD）组64例，脑梗死非痴呆（N-VaD）组51例，选择同期在性别、年龄、文化程度上无差异、无严重疾病的住院体检者31例作为正常对照组。比较4组间的一般资料及简易智能精神状态检查量表（MMSE）评分，比较血清AGEs、sRAGE在不同组别之间的差异，并分析其与AD和VaD的关系。结果 AD组和N-VaD组的AGEs水平高于VaD组和正常对照组，差异有统计学意义（P<0.05）。VaD组和正常对照组之间，AD组和N-VaD组之间的AGEs水平比较，差异无统计学意义（P>0.05）。ROC曲线分析显示血清AGEs对AD有较低诊断价值。Spearman秩相关法分析显示，年龄（r=-0.168，P<0.05）与MMSE评分呈负相关；体重指数（r=0.151，P<0.05）与MMSE评分呈正相关。4组在性别、年龄、糖尿病方面不存在显著性差异（P>0.05）。4组间sRAGE水平比较无显著性差异（P>0.05）。结论 血清AGEs可能与AD的发生、发展有关；AGEs对AD有较低的诊断价值。

Abstract:

Objective To investigate the association of the serum levels of advanced glycation end products (AGEs) and soluble receptor for advanced glycation end product (sRAGE) with Alzheimer's disease (AD) and vascular dementia (VaD).Methods A total of 149 patients who were admitted to Department of Neurology in Lanzhou University Second Hospital from February 2017 to January 2018 were enrolled, and according to Mini-Mental State Examination (MMSE) score and inclusion/exclusion criteria, they were divided into AD group with 34 patients, VaD group with 64 patients (with VaD after cerebral infarction), and N-VaD group with 51 patients (without VaD after cerebral infarction). A total of 31 inpatients on physical examination who had no severe diseases and were well matched for sex, age, and education level were enrolled as normal control group. The four groups were compared in terms of general information, MMSE score, and serum levels of AGEs and sRAGE, and the association of serum levels of AGEs and sRAGE with AD and VaD was analyzed.Results The AD group and the N-VaD group had a significantly higher level of AGEs than the VaD group and the normal control group (P<0.05). There was no significant difference in the level of AGEs between the VaD group and the normal control group, as well as between the AD group and the N-VaD group (P>0.05). The ROC curve showed that serum AGEs had a low value in the diagnosis of AD. The Spearman rank correlation analysis showed that age was negatively correlated with MMSE score (r=-0.168, P<0.05) and body mass index was positively correlated with MMSE score (r=0.151, P<0.05). There were no significant differences in sex, age, and diabetes between the four groups (P>0.05). There was no significant difference in the level of sRAGE between the four groups (P>0.05).Conclusions Serum AGEs may be associated with the development and progression of AD. AGEs have a low value in the diagnosis of AD.