高原地区藏、汉族轻度认知障碍与阿尔茨海默病病人血清氧化低密度脂蛋白和髓过氧化物酶的水平

doi:10.3969/j.issn.1003-9198.2021.01.005

摘要/Abstract

摘要： 目的通过对高原地区藏、汉族轻度认知障碍(MCI)与AD病人血清氧化低密度脂蛋白(oxLDL)和髓过氧化物酶(MPO)含量的分析,探索低氧环境下其与不同民族间MCI和AD发病的关系。方法选取青海省西宁地区藏、汉族的MCI和AD病人以及健康对照人群(NC)各30例。对所有入组者进行一般信息调查,采用MMSE量表评估认知功能,采用ELISA法检测血清oxLDL和MPO水平。oxLDL、MPO水平与MMSE评分的关系采用Spearman相关分析。采用多因素Logistic回归分析藏、汉族MCI和AD的主要危险因素。结果两民族NC组间比较,汉族oxLDL水平显著低于藏族(P<0.05);两民族AD组间比较,汉族oxLDL水平显著低于藏族(P<0.01)。藏族中,MCI组和NC组的oxLDL水平较AD组显著降低(P<0.01),MCI组MPO水平显著低于AD组(P<0.01);汉族中,NC组MPO水平显著低于AD组(P<0.05)。Spearman相关分析显示,汉族oxLDL水平与MMSE评分呈负相关(r=-0.737,P<0.001);藏族oxLDL和MPO水平均与MMSE评分呈负相关(r=-0.794,P<0.001;r=-0.742,P<0.001)。多因素Logistic回归分析显示,oxLDL水平升高是两民族发生MCI和AD的独立危险因素;MPO水平升高是藏族发生MCI和AD的独立危险因素。结论高原地区藏、汉族的认知功能与血清oxLDL和MPO水平有关。联合检测两个指标有助于筛选高危人群。

关键词: 氧化低密度脂蛋白, 髓过氧化物酶, 轻度认知障碍, 阿尔茨海默病, 高原, 藏族

Abstract: Objective To investigate the relationship between the levels of serum oxidized low-density lipoprotein (oxLDL) and myeloperoxidase (MPO) and the incidence of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in Tibetan and Han nationality people at high altitude. Methods The data of 60 patients with MCI, 60 patients with AD and 60 heathly normal control people (NC) of Tibetan and Han nationality living in Xining city of Qinghai Province were collected, with 30 cases in each ethnic subgroup. The cognitive function was assessed with Mini-Mental State Examination (MMSE). The levels of serum oxLDL and MPO were measured by enzyme linked immunosorbent assay. Spearman correlation analysis was performed to evaluate the relationship between the levels of oxLDL and MPO and the score of MMSE. Multivariate Logistic regression analysis was used to screen the risk factors of MCI and AD in Tibetan and Han nationality people. Results The level of oxLDL was significantly higher in Tibetan NC group than that in Han NC group (P<0. 05), and also significantly higher in Tibetan AD group than that in Han AD group (P<0. 01). The level of oxLDL in Tibetan NC group and Tibetan MCI group was significantly lower than that in Tibetan AD group (P<0. 01). The level of MPO was significantly higher in Han AD group than that in Han NC group (P<0. 05), and also significantly higher in Tibetan AD group than that in Tibetan MCI group (P<0. 01). There was a negative correlation between oxLDL level and MMSE score in Han nationality people (r=-0. 737, P<0. 001). The levels of oxLDL and MPO were both negatively related with MMSE score in Tibetan nationality people (r=-0. 794, P<0. 001; r=-0. 742, P<0. 001). Multivariate Logistic regression analysis showed that the increase of oxLDL was an independent risk factor for MCI and AD in the two nationalities, and the increase of MPO was an independent risk factor for MCI and AD in Tibetan nationality. Conclusions The cognitive function of Tibetan and Han nationality people at high altitude is related to serum oxLDL and MPO levels. It is important to monitoring the levels of oxLDL and MPO for screening the risk people.

Key words: oxidized low-density lipoprotein, myeloperoxidase, mild cognitive impairment, Alzheimer's disease, high altitude, Tibetan nationality

中图分类号:

R 749.16

冀磊, 钟欣, 杜灿, 李国峰, 李鸿娟, 朱爱琴. 高原地区藏、汉族轻度认知障碍与阿尔茨海默病病人血清氧化低密度脂蛋白和髓过氧化物酶的水平[J]. 实用老年医学, 2021, 35(1): 15-19.

JI Lei, ZHONG Xin, DU Can, LI Guo-feng, LI Hong-juan, ZHU Ai-qin. Levels of serum oxidized low-density lipoprotein and myeloperoxidase in Tibetan and Han nationality people with mild cognitive impairment and Alzheimer's disease at high altitude[J]. Practical Geriatrics, 2021, 35(1): 15-19.

参考文献

[1] Alzheimer's Association. 2020 Alzheimer's disease facts and figures[J]. Alzheimers Dement, 2020. DOI: 10.1002/alz.12068.
[2] PETERSEN R C. Mild cognitive impairment[J]. Continuum: Minneap Minn, 2016, 22(2):404-418.
[3] CARTER S F, HERHOLZ K, ROSA-NETO P, et al. Astrocyte biomarkers in Alzheimer's disease[J]. Trends Mol Med, 2019, 25(2):77-95.
[4] PETERSEN R C. Mild cognitive impairment as a diagnostic entity[J]. J Inter Med, 2004, 256(3):183-194.
[5] ALBERT M S, DEKSOSKY S T, DICKSON D, et al. The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease [J]. Alzheimers Dement, 2011, 7(3):270-279.
[6] 郭祥星. 中、低海拔地区中老年人轻度认知障碍的研究[D]. 西宁:青海大学, 2016.
[7] MENG J, WU Z, NI J J, et al. Ratanasampil suppresses the hypoxia-related inflammatory responses by inhibiting oxidative stress and NF-κB activation in microglia[J]. J Alzheimers Dis Parkinsonism, 2018, 8(5):451-457.
[8] LIU H, QIU H Y, YANG J, et al. Chronic hypoxia facilitates Alzheimer's disease trough demethylation of γ-secretase by downregulating DNA methyltransferase3b[J]. Alzheimers Dement, 2016, 12(2):130-143.
[9] SHAPIRA R, SOLOMON B, EFRATI S, et al. Hyperbaric oxygen therapy ameliorates pathophysiology of 3xTg-AD mouse model by attenuating neuroinflammation[J]. Neurobiol Aging, 2018, 62(2):105-119.
[10] RANGACHARI V, DEAND N, RANA P, et al. Cause and consequence of Aβ - Lipid interactions in Alzheimer disease pathogenesis[J]. Biochim Biophys Acta Biomembr, 2018, 1860(9):1652-1662.
[11] SOUBHYE J, ALDIB I, DELPORET C, et al. Myeloperoxidase as a target for the treatment of inflammatory syndromes: Mechanisms and Structure Activity Relationships of Inhibitors[J]. Curr Med Chem, 2016, 23(35):3975-4008.
[12] TEJASWI G, SUCHITRA M M, RAJASEKHA D, et al. Myeloperoxidase, protein carbonyls and oxidative stress in coronary artery disease[J]. J India Coll Cardiol, 2017, 7(4):149-152.
[13] TZIKAS S, SCHLAK D, SOPOVA K, et al. Increased myeloperoxidase plasma levels in patients with Alzheimer's disease[J]. J Alzheimers Dis, 2014, 39(3):557-564.
[14] SHANQ J, YAMASHITA T, FUKUI Y, et al. Different associations of plasma biomarkers in Alzheimer's disease, mild cognitive impairment, vascular dementia, and ischemic stroke[J]. J Clin Neurol, 2018, 14(1):29-34.
[15] WU Y, WANG Z, JIA X, et al. Prediction of Alzheimer's disease with serum lipid levels in Asian individuals: a meta-analysis[J]. Biomarkers, 2019, 24(4):341-351.
[16] MARCUM Z A, WALKER R, BOBB J F, et al. Serum cholesterol and incident Alzheimer's disease: Findings from the Adult Changes in Thought Study[J]. J Am Geriatr Soc, 2018, 66(12):2344-2352.