摘要
目的 探究环状RNA DLGAP4(circRNA DLGAP4)、circRNA SAMD4A表达水平与帕金森病(PD)病情严重程度、认知障碍的关系。方法 选取2019年10月—2022年3月河北北方学院附属第一医院神经内三科诊治的PD患者95例为PD组,根据蒙特利尔认知评估量表(MoCA)评分将PD患者分为认知正常亚组54例和认知障碍亚组41例;采用Hoehn-Yahr(H-Y)分期将PD患者分为1期亚组33例、2~3期亚组44例、4~5期亚组18例;另选取医院同期体检健康者95例为健康对照组。比较各组血清circRNA DLGAP4、circRNA SAMD4A表达水平及MoCA评分。Pearson法分析PD患者血清circRNA DLGAP4、circRNA SAMD4A表达水平与MoCA评分的相关性,Logistic回归分析PD患者发生认知障碍的影响因素,受试者工作特征曲线(ROC)分析血清circRNA DLGAP4、circRNA SAMD4A对PD患者发生认知障碍的诊断价值。结果 与健康对照组比较,PD组患者血清circRNA DLGAP4表达水平、MoCA评分降低(t/P=47.612/<0.001、26.821/<0.001),血清circRNA SAMD4A表达水平升高(t/P=23.461/<0.001)。认知障碍亚组PD患者年龄、血清circRNA SAMD4A表达水平高于认知正常亚组(t/P=2.515/0.014、6.693/<0.001),受教育年限、血清circRNA DLGAP4表达水平、MoCA评分低于认知正常亚组(t/P=5.162/<0.001、8.289/<0.001、23.017/<0.001);1期亚组、2~3期亚组、4~5期亚组PD患者血清circRNA DLGAP4表达水平、MoCA评分依次降低(F/P=103.287/<0.001、230.136/<0.001),血清circRNA SAMD4A表达水平依次升高(F/P=51.949/<0.001);Pearson法分析显示,PD患者血清circRNA DLGAP4表达水平与MoCA评分呈正相关(r/P=0.557/<0.001),血清circRNA SAMD4A表达水平与MoCA评分呈负相关(r/P=-0.598/<0.001);Logistic回归分析显示,受教育年限长、血清circRNA DLGAP4高是PD患者发生认知障碍的保护因素[OR(95%CI)=0.698(0.568~0.857)、0.580(0.476~0.707)],年龄大、血清circRNA SAMD4A高是其危险因素[OR(95%CI)=2.462(1.612~3.760)、3.836(2.225~6.615)];血清circRNA DLGAP4、circRNA SAMD4A及二者联合诊断PD患者发生认知障碍的曲线下面积(AUC)分别为0.791、0.852、0.948,二者联合诊断的AUC优于各自单独诊断(Z/P=2.950/0.003、2.081/0.037)。结论 PD患者血清circRNA DLGAP4表达下调,circRNA SAMD4A表达上调,检测血清circRNA DLGAP4、circRNA SAMD4A水平有助于临床评估PD患者病情严重程度,且二者联合有利于判定患者是否发生认知障碍。
Objective To explore the relationship between the expression levels of circular RNA DLGAP4(circRNA DLGAP4),circRNA SAMD4 A and the severity of Parkinson’s disease(PD) and cognitive impairment.Methods From October 2019 to March 2022,95 patients with PD diagnosed and treated in the Third Department of Neurology of the First Affiliated Hospital of Hebei North University were selected as the PD group.According to the score of Montreal Cognitive Assessment Scale(MoCA),the PD patients were divided into 54 patients with normal cognition and 41 patients with cognitive impairment;By Hoehn Yahr(H-Y) staging,patients with PD were divided into three subgroups:33 patients in stage 1 subgroup,44 patients in stage 2-3 subgroup,and 18 patients in stage 4-5 subgroup;In addition,95 healthy people in the same period were selected as the healthy control group.Serum circRNA DLGAP4,circRNA SAMD4 A expression levels and MoCA scores were compared in each group.Pearson’s method was used to analyze the correlation between the expression level of circRNA DLGAP4,circRNA SAMD4 A and MoCA score in the serum of PD patients.Logistic regression analysis was used to analyze the influencing factors of cognitive impairment in PD patients.Subjects’ work characteristic curve(ROC) was used to analyze the diagnostic value of serum circRNA DLGAP4,circRNA SAMD4 A for cognitive impairment in PD patients.Results Compared with the healthy control group,the expression level of DLGAP4 and MoCA score in serum of patients with PD decreased(t/P=47.612/<0.001,26.821/<0.001),and the expression level of SAMD4 A in serum increased(t/P=23.461/<0.001).The age,serum circRNA SAMD4 A expression level of PD patients in cognitive impairment subgroup were higher than those in cognitive normal subgroup(t/P=2.515/0.014,6.693/<0.001),and the years of education,serum circRNA DLGAP4 expression level and MoCA score were lower than those in cognitive normal subgroup(t/P=5.162/<0.001,8.289/<0.001,23.017/<0.001);The serum circRNA DLGAP4 expression level and MoCA score of PD patients in stage 1 subgroup,stage 2-3 subgroup and stage 4-5 subgroup decreased in turn(F/P=103.287/<0.001,230.136/<0.001),and the serum circRNA SAMD4 A expression level increased in turn(F/P=51.949/<0.001);Pearson analysis showed that the expression level of serum circRNA DLGAP4 was positively correlated with MoCA score(r/P=0.557/<0.001),and the expression level of serum circRNA SAMD4 A was negatively correlated with MoCA score(r/P=-0.598/<0.001);Logistic regression analysis showed that long years of education and high serum circRNA DLGAP4 were protective factors for cognitive impairment in patients with PD [OR(95%CI)=0.698(0.568-0.857),0.580(0.476-0.707)],while age and high serum circRNA SAMD4 A were risk factors [OR(95%CI)=2.462(1.612-3.760),3.836(2.225-6.615)];The area under the curve(AUC) of serum circRNA DLGAP4,circRNA SAMD4 A and their combination in the diagnosis of cognitive impairment in PD patients were 0.791,0.852 and 0.948,respectively.The AUC of their combination was better than that of their individual diagnosis(Z/P=2.950/0.003,2.081/0.037).Conclusion The expression of circRNA DLGAP4 is down regulated and the expression of circRNA SAMD4 A is up regulated in the serum of PD patients.The detection of the levels of circRNA DLGAP4 and circRNA SAMD4 A in the serum is helpful for clinical evaluation of the severity of PD patients,and the combination of the two is helpful for determining whether patients have cognitive impairment.
作者
柴琴琴
范磊
刘星亮
岳秉宏
Chai Qinqin;Fan Lei;Liu Xingliang;Yue Binghong(Department of Neurology,the First Hospital Affiliated to Hebei North University,Zhangjiakou 075000,China)
出处
《疑难病杂志》
CAS
2022年第10期1024-1029,共6页
Chinese Journal of Difficult and Complicated Cases
基金
河北省医学科学研究课题计划项目(20200204)。
关键词
帕金森病
环状RNA
病情严重程度
认知障碍
Parkinson’s disease
Circular RNA
Disease severity
Cognitive impairment
作者简介
通信作者:岳秉宏,E-mail:z19803031016@163.com。
