中老年人血液常见氨基酸水平与轻度脑白质疏松症的相关性  

Correlation between blood levels of common amino acids and mild leukoaraiosis in the middle-aged and elder people

作　　者：邢怡文 巴晓红 Xing Yiwen;Ba Xiaohong(Department of Neurology,The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,Liaoning Province,China)

机构地区：[1]锦州医科大学附属第一医院神经内科,辽宁锦州121000

出　　处：《首都医科大学学报》2024年第1期163-168,共6页Journal of Capital Medical University

摘　　要：目的探讨中老年人血液常见氨基酸水平与早期轻度脑白质疏松症(leukoaraiosis,LA)的关系及其对轻度LA的筛查诊断价值。方法本研究纳入2020年8月至2021年11月因头晕或头痛等主诉于锦州医科大学附属第一医院神经内科住院的患者,根据头颅磁共振检查结果入组21例非LA患者和31例轻度LA患者,使用串联质谱法采集患者23种血液氨基酸代谢物水平,比较两组患者血液氨基酸水平差异,使用Logistic回归分析模型和受试者工作特征(receiver operating characteristic,ROC)曲线研究轻度LA的独立危险因素以及血液氨基酸水平对轻度LA的筛查诊断价值。结果年龄、冠状动脉粥样硬化性心脏病史、酪氨酸和缬氨酸水平在两组间差异具有统计学意义(P<0.05)。多因素Logistic回归显示,年龄(OR=1.232,95%CI:1.068~1.420)和缬氨酸水平(OR=1.059,95%CI:1.009~1.111)是轻度LA的独立危险因素,年龄增长和缬氨酸水平升高,发生轻度LA的风险增加。ROC曲线分析结果表明,年龄和缬氨酸筛查轻度LA的最佳截断值分别是58.5岁和96.305μmol/L,ROC曲线下面积分别为0.710(95%CI:0.565~0.856,P<0.05)和0.674(95%CI:0.509~0.840,P<0.05)。结论血液中常见氨基酸水平变化与早期轻度LA具有相关性,年龄增长和缬氨酸水平升高是轻度LA的独立危险因素,两者在筛查轻度LA方面具有一定的临床价值。Objective To investigate the relationship between common amino acids in the blood and early mild leukoaraiosis(LA)in middle-aged and older people and its diagnostic value in screening for mild LA.Methods Patients who were hospitalized in the Department of Neurology,The First Affiliated Hospital of Jinzhou Medical University with complaints of dizziness or headache from August 2020 to November 2021 were included in this study,and 21 non-LA patients and 31 patients with mild LA were enrolled based on the results of head magnetic resonance imaging(MRI).Tandem mass spectrometry was used to collect the levels of 23 blood amino acid metabolites from the patients,and the differences in blood amino acid levels between the two groups were compared.Logistic regression analysis models and receiver operating characteristic(ROC)curves were used to investigate the independent risk factors for mild LA and the screening and diagnostic value of blood amino acid levels for mild LA.Results The differences in age,history of coronary artery disease,tyrosine and valine were statistically significant in the non-LA group compared with the mild LA group(P<0.05).Multifactorial Logistic regression indicated that age(OR=1.232,95%CI:1.068-1.420)and valine levels(OR=1.059,95%CI:1.009-1.111)were independent risk factors affecting mild LA,and increasing age and elevated valine levels increased the risk of developing mild LA.The results of the ROC curve analysis indicated that the optimal cut-off values for age and valine screening for mild LA were 58.5 years and 96.305μmol/L,respectively,with an area under the ROC curve of 0.710(95%CI:0.565-0.856,P<0.05)and 0.674(95%CI:0.509-0.840,P<0.05),respectively.Conclusion Changes in blood levels of common amino acids correlate with early mild LA,and increasing age and elevated valine levels are independent risk factors for mild LA,both of which are of clinical value in screening for mild LA.

关 键 词：脑白质疏松症 氨基酸 缬氨酸 

分 类 号：R741[医药卫生—神经病学与精神病学]