Study On The Relationship Between The Relative Telomere Length Of Peripheral Blood Leukocytes,the Concentration Of Serum Neurofilament Light Chain And Aging In Patients With Chronic Insomnia

Objective Our objective is to study the relationship between the telomere repeat copy number to single gene copy number ratio(TSR)of peripheral blood leukocytes、the concentration of serum neurofilament light chain(sNfL)and aging in patients with chronic insomnia(CID).Methods From October 2018 to October 2019,120 CID patients in Department of Neurology,Huainan First People’s Hospital were collected,and a total of 80 healthy volunteers who matched the age,gender,race,and education level of the case group were recruited as the control group.The general data(age,gender,height,weight,education level,etc.)of the subjects were collected.The total subjective sleep status,anxiety and depression mood and cognitive function of the subjects were assessed with the Athens Insomnia Scale(AIS),Insomnia Severity Index scale(ISI),Pittsburgh Sleep Quality Index scale(PSQI),Hamilton Depression Rating Scale-17(HMD-17),Hamilton Anxiety Scale-14(HAMA-14)and Montreal Cognitive Assessment scale(MoCA).From 8:00 to 9:00 in the morning,4 ml of fasting elbow venous blood was drawn from the subjects.TSR of peripheral blood leukocytes was measured by real-time fluorescence quantitative polymerase chain reaction and sNfL concentration was measured by enzyme-linked immunosorbent assay.The changes of TSR in peripheral blood leukocytes and sNfL concentration of the two groups and their relationship with age were analyzed.The subgroups were analyzed according to the different clinical characteristics of CID patients,such as gender,age,education level,sleep quality and the evaluation results of various scales.Results(1)The total scores of AIS,PSQI,ISI,HAMA-14 and HAMD-17 scales in CID group were higher than those in healthy control group(P<0.001);(2)TSR of peripheral blood leukocytes in CID group was significantly shorter than that in healthy control group(P<0.001).In patients with CID,the difference of TSR of peripheral blood leukocytes in different sleep quality subgroups was statistically significant(P<0.001).TSR of peripheral blood leukocytes in the subgroup with worst sleep quality was significantly shorter than that in the subgroup with fair sleep quality(P<0.05)and the subgroup with poor sleep quality(P<0.001).TSR of peripheral blood leukocytes in the≥60-year-old subgroup was significantly shorter than that in the <60-year-old subgroup(P<0.001).The difference in TSR of peripheral blood leukocytes in different subgroups of total sleep time was statistically significant(P<0.001),and the difference was statistically significant after each pairwise comparison.There was a significant difference in TSR of peripheral blood leukocytes in different subgroups of sleep efficiency(P<0.001).The difference was statistically significant after each pairwise comparison.The difference of TSR of the peripheral blood between subgroups with different levels of anxiety was statistically significant(P<0.001).TSR of peripheral blood in the subgroups with mild anxiety,moderate anxiety,and severe to extreme anxiety was significantly shorter than that in the subgroup without anxiety(P<0.001,P<0.05,P<0.001).The difference of TSR of peripheral blood leukocytes in different cognitive dysfunction subgroups was statistically significant(P<0.001).TSR of peripheral blood leukocytes in the subgroup with mild cognitive dysfunction and moderate to severe cognitive dysfunction was shorter than that in the group with normal cognitive function(P<0.05,P<0.001).(3)There was a significant negative correlation between TSR of peripheral blood leukocytes and age(CID group:r =-0.812,P<0.001;healthy control group:r =-0.985,P<0.001).Sleep efficiency(β = 0.399,P<0.001)and sleep rhythm disorder(β=-0.101,P<0.001)were independent factors which can influence TSR of peripheral blood leukocyte.(4)In CID patients,the sNfL concentration in the ≥60-year-old subgroup was higher than that in the <60-year-old subgroup(P<0.001).There was a statistically significant difference in sNfL concentration in the subgroups with different total sleep time(P<0.001).The sNfL concentration in the subgroup with total sleep time less than 2 hours was higher than that in the subgroup with total sleep time of 2 to 4 hours and 4 to 6 hours(P<0.001).There was a significant difference in sNfL concentration among the subgroups of different sleep efficiency(P<0.001).And the sNfL concentration in the subgroup with sleep efficiency less than 40% was significantly higher than that in the subgroup with sleep efficiency of 40% ~ 60% and more than 60%(P<0.001).The difference in sNfL concentration in different subgroupswith different levels of anxiety was statistically significant(P<0.05).The sNfL concentration in the subgroups with mild anxiety and severe to extremely severe anxiety was significantly higher than that in the subgroup without anxiety(both P<0.05).The difference in sNfL concentration of different cognitive dysfunction subgroups was statistically significant(P<0.001).The sNfL concentration in the mild and moderate to severe cognitive dysfunction subgroups was significantly higher than that in the normal cognitive function subgroup(P<0.05,P<0.001).(5)There was a significant positive correlation between sNfL concentration and age(CID group:r=0.945,P<0.001;the healthy control group:r=0.997,P<0.001);Subjective sleep quality(β=-10.693,P<0.05),and sleep efficiency(β=-27.354,P<0.001),sleep rhythm disorder(β=4.258,P<0.05)were independent factors which can influence sNfL concentration.Conclusion(1)The patients with CID often have different degrees of anxiety,depression and cognitive dysfunction.(2)The TSR of peripheral blood leucocytes shortens with the increase of age.CID accelerates the shortening process of TSR of peripheral blood leucocytes related to age.The lower the sleep efficiency,the more obvious the sleep rhythm disorder,and the shorter the TSR of peripheral blood leucocytes will be.(3)The concentration of sNfL increases with the increase of age.The lower the sleep efficiency,the more obvious the sleep rhythm disorder,the worse the subjective sleep quality,the higher the sNfL concentration will be;CID accelerated the age-related nerve injury(aging)process.(4)Therefore,CID can accelerate the aging process.