非痴呆型脑小血管病患者血清Hcy TGF-β1及BDNF表达与认知功能障碍的关系Relationship between the expressions of Hcy,TGF-β1,BDNF and cognitive dysfunction in patients with non-dementia type cerebrovascular disease
石伟纲;薛文俊;杜迎春;
摘要(Abstract):
目的探讨非痴呆型脑小血管病(cerebral small vessel disease,CSVD)患者血清同型半胱氨酸(homocysteine,Hcy)、转化生长因子-β1(transformed growth factor-1,TGF-β1)及脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)表达与认知功能障碍的关系。方法选取117例CSVD患者为研究对象,根据是否存在认知功能障碍(vascular cognitive impairment of none dementia,VCIND)分为VCIND组(41例)和CSVD组(76例)。检测2组血清Hcy、TGF-β1、BDNF水平,分析VCIND组血液指标水平与蒙特利尔认知评估(MoCA)评分的相关性。结果 VCIND组患者血清Hcy水平较CSVD组升高,血清TGF-β1、BDNF水平较CSVD组降低(P<0.05)。Logistic回归分析显示,Hcy为VCIND的危险因素(B=0.334,OR=1.396,P=0.000),而TGF-β1、BDNF为VCIND的保护因素(B=-0.066,OR=0.937,P=0.005;B=-0.751,OR=0.472,P=0.004)。血清Hcy水平与MoCA评分呈负相关,血清TGF-β1、BDNF表达与MoCA评分呈正相关性(P<0.05)。结论 Hcy、TGF-β1及BDNF表达与VCIND的发生有关,其血清水平能够反映患者认知功能障碍程度。
关键词(KeyWords): 脑小血管病;认知功能障碍;同型半胱氨酸;转化生长因子-β1;脑源性神经营养因子
基金项目(Foundation): 洛阳市科技攻关项目(编号:1725001A-8)
作者(Authors): 石伟纲;薛文俊;杜迎春;
参考文献(References):
- [1] PENG D,GERIATRIC NEUROLOGY GROUP,CHINESE SOCIETY OF GERIATRICS,et al.Clinical practice guideline for cognitive impairment of cerebral small vessel disease[J].Aging Med (Milton),2019,2(2):64-73.DOI:10.1002/agm2.12073.
- [2] GEORGAKIS M K,MALIK R,ANDERSON C D,et al.Genetic determinants of blood lipids and cerebral small vessel disease:role of high-density lipoprotein cholesterol[J].Brain,2020,143(2):597-610.DOI:10.1093/brain/awz413.
- [3] DOBRYNINA L A,SHABALINA A A,SHAMTIEVA K V,et al.The predictive value of salt sensitivity and osmotic fragility in the development of cerebral small vessel disease[J].Int J Mol Sci,2020,21(6).pii:E2036.DOI:10.3390/ijms21062036.
- [4] SENGUPTA P,GANGULY J,PAL S,et al.Pattern of cognitive deficits in vascular dementia[J].Indian J Med Res,2019,149(4):503-507.DOI:10.4103/ijmr.IJMR_1336_17.
- [5] DAMANIK J,MAYZA A,RACHMAN A,et al.Association between serum homocysteine level and cognitive function in middle-aged type 2 diabetes mellitus patients[J].PLoS One,2019,14(11):e0224611.DOI:10.1371/journal.pone.0224611.
- [6] HU Y,CHEN W,WU L,et al.TGF-β1 restores hippocampal synaptic plasticity and memory in alzheimer model via the PI3K/Akt/Wnt/β-catenin signaling pathway[J].J Mol Neurosci,2019,67(1):142-149.DOI:10.1007/s12031-018-1219-7.
- [7] INGLéS M,GAMBINI J,MAS-BARGUES C,et al.Brain-derived neurotrophic factor as a marker of cognitive frailty[J].J Gerontol A Biol Sci Med Sci,2017,72(3):450-451.DOI:10.1093/gerona/glw145.
- [8] PASI M,CORDONNIER C.Clinical Relevance of Cerebral Small Vessel Diseases[J].Stroke,2020,51(1):47-53.DOI:10.1161/STROKEAHA.119.024148.
- [9] LI P,WANG Y,JIANG Y,et al.Cerebral small vessel disease is associated with gait disturbance among community-dwelling elderly individuals:the Taizhou imaging study[J].Aging (Albany NY),2020,12(3):2814-2824.DOI:10.18632/aging.102779.
- [10] AMIN AL OLAMA A,WASON J M S,TULADHAR A M,et al.Simple MRI score aids prediction of dementia in cerebral small vessel disease[J].Neurology,2020,94(12):e1294-e1302.DOI:10.1212/WNL.0000000000009141.
- [11] OU C,LI C,AN X,et al.Assessment of cognitive impairment in patients with cerebral infarction by MMSE and MoCA scales[J].J Coll Physicians Surg Pak,2020,30(3):342-343.DOI:10.29271/jcpsp.2020.03.342.
- [12] O'DRISCOLL C,SHAIKH M.Cross-cultural applicability of the montreal cognitive assessment (MoCA):a systematic review[J].J Alzheimers Dis,2017,58(3):789-801.DOI:10.3233/JAD-161042.
- [13] PARADISE M B,SACHDEV P S.Vascular Cognitive Disorder[J].Semin Neurol,2019,39(2):241-250.DOI:10.1055/s-0039-1678582.
- [14] LAI K S P,LIU C S,RAU A,et al.Peripheral inflammatory markers in Alzheimer's disease:a systematic review and meta-analysis of 175 studies[J].J Neurol Neurosurg Psychiatry,2017,88(10):876-882.DOI:10.1136/jnnp-2017-316201.Epub 2017 Aug 9.
- [15] BARONI L,BONETTO C,RIZZO G,et al.Association between cognitive impairment and Vitamin B12,folate,and homocysteine status in elderly adults:a retrospective study[J].J Alzheimers Dis,2019,70(2):443-453.DOI:10.3233/JAD-190249.
- [16] ESTRADA L D,OLIVEIRA-CRUZ L,CABRERA D.Transforming growth factor beta type I role in neurodegeneration:implications for alzheimer′s disease[J].Curr Protein Pept Sci,2018,19(12):1180-1188.DOI:10.2174/1389203719666171129094937.
- [17] CECHOVA K,ANDEL R,ANGELUCCI F,et al.Impact of APOE and BDNF Val66Met gene polymorphisms on cognitive functions in patients with amnestic mild cognitive impairment[J].J Alzheimers Dis,2020,73(1):247-257.DOI:10.3233/JAD-190464.