血浆载脂蛋白M与阿尔茨海默病的相关性研究  

Association between plasma apolipoprotein M and AD

作　　者：辛佳艳 刘芝兰 黄晓 朱晓艳 孙颖 王庆松 杨绍杰 向阳 Xin Jiayan;Liu Zhilan;Huang Xiao;Zhu Xiaoyan;Sun Ying;Wang Qingsong;Yang Shaojie;Xiang Yang(Department of Clinical Medicine,North Sichuan Medical College,Nanchong 637000,Sichuan Province,China)

机构地区：[1]川北医学院临床医学系,南充637000 [2]解放军西部战区总医院内分泌科 [3]解放军西部战区总医院中心实验室 [4]四川省医学科学院·四川省人民医院老年科 [5]解放军西部战区总医院神经内科 [6]成都市第八人民医院神经内科 [7]四川省医学科学院·四川省人民医院神经内科

出　　处：《中华老年心脑血管病杂志》2022年第5期464-467,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81801090);四川省科技计划项目(2019YFS0213);军队医学科技青年培育计划(19QNP065)。

摘　　要：目的 探讨载脂蛋白M(apoM)与阿尔茨海默病(AD)的相关性及其对AD的诊断价值。方法 选取2021年3~6月于四川省人民医院、西部战区总医院和成都市第八人民医院收治的AD患者50例作为病例组,另选取同期认知功能正常者50例作为对照组。采用ELISA法测血浆apoM和神经丝轻链蛋白(NfL)水平,采用Spearman秩相关分析,采用二元logistic回归分析,采用ROC曲线分析。结果 病例组血浆apoM及NfL水平显著高于对照组(P<0.01);血浆apoM与NfL呈正相关(r=0.471,P<0.01),与简易智能状态检查量表评分(r=-0.374,P<0.01)、蒙特利尔认知评估量表评分(r=-0.417,P<0.01)呈负相关,与日常生活活动能力量表评分(r=0.399,P<0.01)呈正相关;二元logistic回归分析校正性别、年龄等因素后,血浆apoM仍与AD的发生显著相关(OR=1.058,95%CI:1.026~1.091,P=0.000);ROC曲线分析显示,血浆apoM诊断AD的曲线下面积为0.724,诊断最佳临界值为61.78 mg/L,敏感性为62%,特异性为76%,具有诊断AD的潜力。结论 血浆apoM与AD的发生显著相关,可能为AD临床诊断和病情评估提供参考。Objective To study the association between apolipoprotein M(apoM) and AD and the value of apoM for diagnosing AD.Methods Fifty AD patients admitted to Sichuan Provincial People’s Hospital, Western Theater Command General Hospital and Chengdu No.8 People’s Hospital from March 2021 to June 2021 served as AD group and 50 persons with normal cognitive function served as control group.Their plasma apoM and neurofilament light chain(NfL) levels were measured by ELISA and analyzed by Spearman correlation analysis, binary logistic regression analysis and ROC curve analysis respectively.Results The plasma apoM and NfL levels were significantly higher in AD group than in control group(P<0.01).Spearman correlation analysis showed that the plasma apoM was positively associated with the plasma NfL and daily life quantitative scale score(r=0.471,P<0.01;r=0.399,P<0.01) and negatively associated with the MMSE scale score(r=-0.374,P<0.01) and MoCA scale score(r=-0.417,P<0.01).Binary logistic regression analysis revealed that the plasma apoM was still closely associated with AD after adjustment of sex, age and other factors(OR=1.058,95%CI:1.026-1.091,P=0.000).ROC curve analysis displayed that the AUC of plasma apoM for diagnosing AD was 0.724 with an optimal cutoff value of 61.78 mg/L,a sensitivity of 62% and a specificity of 76%.Conclusion Plasma apoM is closely associated with AD and can thus provide reference for the clinical diagnosis and assessment of AD.

关 键 词：载脂蛋白类 阿尔茨海默病 神经微丝蛋白质类 生物标记 早期诊断 

分 类 号：R749.16[医药卫生—神经病学与精神病学]