血清前蛋白转化酶枯草杆菌蛋白酶/kexin 9型与健康体检者血管源性脑白质高信号的相关性  

Correlation between serum proprotein convertase subtilisin/kexin type 9 and white matter hyperintensities of presumed vascular origin in healthy individuals

作　　者：舒秀丽 李芸 黄震乾 赵颖 张晓浩 朱武生 谢怡 刘新峰 Shu Xiuli;Li Yun;Huang Zhenqian;Zhao Ying;Zhang Xiaohao;Zhu Wusheng;Xie Yi;Liu Xinfeng(Department of Neurology,Jinling Hospital Affiliated to Medical School of Nanjing University,Nanjing 210002,China;Department of Neurology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210002,China)

机构地区：[1]南京大学医学院附属金陵医院神经内科,南京210002 [2]南京医科大学附属南京医院(南京市第一医院)神经内科,南京210002

出　　处：《国际脑血管病杂志》2024年第10期754-759,共6页International Journal of Cerebrovascular Diseases

基　　金：江苏省自然科学基金(BK20221553,BK20241674)。

摘　　要：目的探讨血清前蛋白转化酶枯草溶菌素/kexin9型(proprotein convertase subtilisin/kexin type 9,PCSK9)水平与健康人群脑白质高信号(white matter hyperintensities,WMHs)的相关性。方法前瞻性连续纳入在东部战区总医院(2023年4月至2023年12月)和南京市第一医院河西院区(2024年3月至2024年4月)行常规体检的健康人群。采用酶联免疫吸附法检测血清PCSK9水平。应用Fazekas量表评定WMHs严重程度(总分0~6分),并分为无或轻度WMHs组(0~2分)和中至重度WMHs组(3~6分)。应用多变量logistic回归分析确定血清PCSK9水平与WMHs严重程度的独立相关性。结果共纳入177例受试者,男性110例(62.1%),年龄(66.7±10.1)岁,中位血清PCSK9水平为203.9 ng/L。根据Fazekas评分,无或轻度WMHs组102例(51.6%),中至重度WMHs组(42.4%)例。单因素方差分析表明,血清PCSK9水平随着WMHs总分的增加而显著升高(P=0.001)。中至重度WMHs组血清PCSK9水平显著高于无或轻度WMHs组[(437.2±260.4)ng/L对(217.9±141.7)ng/L;P=0.001]。多变量logistic回归分析显示,校正年龄、性别及其他混杂因素后,血清PCSK9水平较高与中至重度WMHs存在显著独立相关性(优势比3.201,95%置信区间2.107~5.082;P=0.001)。结论血清PCSK9水平较高是健康人群存在中至重度WMHs的独立危险因素。Objective To investigate the correlation between serum proprotein convertase subtilisin/Kexin type 9(PCSK9)level and white matter hyperintensities(WMHs)in healthy population.Methods Consecutive healthy individuals underwent routine physical examinations at the Department of Neurology,Jinling Hospital Affiliated to Medical School of Nanjing University(April 2023 to December 2023)and Hexi Branch of Nanjing First Hospital(March 2024 to April 2024)were included prospectively.Enzyme-linked immunosorbent assay was used to detect serum PCSK9 level.The Fazekas scale was used to assess the severity of WMHs(total score 0-6)and they were divided into no or mild WMHs group(0-2)and moderate to severe WMHs group(3-6).Multivariate logistic regression analysis was used to determine the independent correlation between the serum PCSK9 level and the severity of WMHs.Results A total of 177 subjects were enrolled,including 110 males(62.1%),aged 66.7±10.1 years.The median serum PCSK9 level was 203.9 ng/L.According to the Fazekas score,there were 102 patients(51.6%)in the no or mild WMHs group,and 75(42.4%)in the moderate to severe WMHs group.One way analysis of variance showed that serum PCSK9 level significantly increased with the increase of WMHs total score(P=0.001).The serum PCSK9 level in the moderate to severe WMHs group was significantly higher than that in the no or mild WMHs group(437.2±260.4 ng/L vs.217.9±141.7 ng/L;P=0.001).Multivariate logistic regression analysis showed that after adjusting for age,gender,and other confounding factors,there was a significant independent correlation between higher serum PCSK9 level and moderate to severe WMHs(odds ratio 3.201,95%confidence interval 2.107-5.082;P=0.001).Conclusion Higher serum PCSK9 level is an independent risk factor for moderate to severe WMHs in healthy individuals.

关 键 词：白质 脑小血管疾病 疾病严重程度指数 前蛋白转化酶9 磁共振成像 危险因素 生物标志物 

分 类 号：R54[医药卫生—心血管疾病]