| OBJECTIVE:Alzheimer's Disease?AD?is one of the most common diseases and the fifth cause of death in the elderly.Since the global aging process accelerating,the prevalence of AD increases gradually,which bringing heavy pressure and burden to both families and society.AD is divided into three stages according to the course of disease:preclinical stage,Mild Cognitive Impairment?MCI?,and dementia.MCI is an intermediate stage from cognitive normal to dementia.The academic community agrees that the MCI stage is a critical period for the prevention and treatment of AD.However,the contradiction is that there is no effective treatment to change the course of AD.However,the sooner the drug is relieved,the more patient benefits.Early diagnosis and treatment of the disease is a major public health problem that the whole world is actively studying and urgently needs to solve.The latest diagnostic criteria for AD emphasized the importance and necessity of biomarkers.Currently,AD-related biomarkers are mainly detected by cerebrospinal fluid or blood,but the acquisition of cerebrospinal fluid is relatively difficult,while the detection of blood biomarkers is more convenient and feasible for which the trauma to the patient is smaller.A?1-42is a product of cleavage of amyloid precursor proteir?APP?,which is the main component of senile plaques that form the characteristic pathological markers of AD.Advanced glycation end products?AGEs?are mainly end products produced by non-enzymatic glycosylation of free amino groups of macromolecules such as proteins and aldehyde groups of reducing sugars.In recent years,many studies have found that AGEs and their receptors?RAGE?are associated with cognitive impairment.AGEs can cause neurotoxic damage,promote neuronal apoptosis,and increase in blood through various pathways.AGEs are associated with cognitive dysfunction in AD patients and believed that AGEs may be one of the causes of AD.Therefore,this study aimed to investigate the changes of A?1-42,AGEs,sRAGE in serum of patients with AD and its relationship with cognitive function,thus to understanding their value in the early diagnosis of AD.METHOD:A total of 59 patients with AD admitted from March 2018 to February 2019 were enrolled,including 30 patients with mild cognitive impairment,29 patients with dementia,and 29 healthy controls.The levels of serum AGEs,sRAGE,and A?1-42 were measured and compared.All data was processed by the SPSS 22.0 statistical package.RESULT:Comparison of MMSE and MoCA scores in the three groups:Compared with the normal control group,the MMSE and MoCA scores in the MCI group and the dementia group were significantly lower,the difference was statistically significant?P<0.01,P<0.01?.The score of the MCI group was significantly higher than that of the dementia group?P<0.01?.Comparison of serum A?1-42-42 values of the three groups:One-way ANOVA showed that the levels of serum A?1-42-42 in the MCI group and the dementia group were significantly lower than those in the normal control group?P<0.01?,and the level of the dementia group was significantly lower than that of the MCI group?P<0.01?.Comparison of serum AGEs values of the three groups:The three-way variance comparison showed that the serum AGEs levels in the MCI group and the dementia group were significantly lower than those in the normal control group?P<0.05,P<0.01?.The serum AGEs levels in the MCI group were significantly higher than the dementia group?P<0.05?.Comparison of serum sRAGE values of the three groups:Comparison of the three-way variance of the three groups showed that compared with dementia,the serum sRAGE levels in the normal control group and the MCI group were significantly lower?P<0.01,P<0.05?.There were no significant differences in age,gender,years of schooling,blood pressure and biochemical indicators between the three groups?P>0.05?.There were no significant differences in TG,TC,LDL,HDL,Hcy,HbA1c,UA,systolic blood pressure and diastolic blood pressure between the AD group,the MCI group and the healthy control group?P<0.05?.According to spearman correlation analysis,the MMSE and MoCA scores of patients in this study were positively correlated with A?1-42 levels,and the difference was statistically significant?r=0.442,P<0.01;r=0.372,P<0.01?.The MMSE and MoCA scores of patients were positively correlated with AGEs,and the difference was statistically significant?r=0.237,P<0.05;r=0.221,P<0.05?.The MMSE and MoCA scores of patients in this study were negatively correlated with sRAGE,and the difference was statistically significant?r=-0.260,P<0.05;r=-0.244,P<0.05?.In this study,the MMSE and MoCA scores were negatively correlated with age,and positively correlated with the number of years of education.The difference was statistically significant?P<0.05?.In addition,there were no significant correlations between TG,TC,LDL,HDL,Hcy,HbA1c,UA,systolic blood pressure and diastolic blood pressure in the study?P>0.05?.Serum A?1-42 receiver operating characteristic curve indicates that A?1-42 has a higher diagnostic value for AD.CONCLUSION:In this study,serum A?1-42 levels in AD patients gradually decreased with increasing course of disease,and were positively correlated with MMSE and MoCA scores,which were specific and sensitive indicators for AD diagnosis.The MMSE and MoCA scores of patients in this study were positively correlated with AGEs and negatively correlated with sRAGE,which was not consistent with most literature reports.The analysis may be related to the small sample size in this study.This study analyzed that cognitive dysfunction was positively correlated with age and negatively correlated with years of schooling.In addition,the incidence of women in this study was higher than that of men,which is consistent with most current epidemiological studies. |
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