血清YKL40与阿尔茨海默病及2型糖尿病的相关研究

发布时间：2018-05-30 17:18

本文选题：YKL40 + 阿尔茨海默病　；参考：《大连医科大学》2017年硕士论文

【摘要】：目的:阿尔茨海默病(alzheimer’s disease,AD)是一种进行性发展、以认知功能障碍及行为改变为特征的中枢神经系统退行性疾病,发生于老年和老年前期。临床表现为记忆力减退、时间空间定向力下降、言语障碍、计算力下降、视空间功能和执行能力受损、失用、失认、抽象思维损害以及人格和行为的改变。2型糖尿病(type 2 diabetes mellitus,T2DM)主要的特征是血葡萄糖水平异常升高和胰岛素抵抗,是由于胰岛素分泌不足和(或)作用缺陷所引起,其患病率正随着人口老龄化、不健康的饮食习惯和缺乏锻炼而迅速增加,呈逐渐增长的流行趋势。虽然AD和T2DM是两种相对独立的疾病,但有证据显示这两种疾病存在密切的病理生理学联系。研究表明,T2DM作为认知功能减退的独立危险成分,可以促进AD的发生发展。有研究显示血清炎症因子YKL40的水平在AD中是升高的,在T2DM中也是升高的。本文旨在探索炎症因子YKL40在AD合并T2DM中的表达水平,并期望可以为研究T2DM与AD共病的潜在机制提供线索。方法:本研究中,病例组来自2014-2016年住院于大连医科大学附属第一医院患者,共60名,其中AD患者20名(AD组),AD合并T2DM患者20名(AD合并T2DM组),T2DM患者20名(T2DM组)。AD组患者的诊断符合2011年修订的NINCDS-ADRDA诊断标准,T2DM组患者的诊断采纳目前国际上通用的世界卫生组织糖尿病专家委员会(1999)提出的诊断标准。正常对照患者20名(对照组),为同时期于大连医科大学附属第一医院体检中心体检合格的健康人员。实验前通过简易精神状况检查量表(MMSE)、蒙特利尔认知评估量表(Mo CA)及画钟试验(CDT)对全部入组患者都做了认知功能初步评估。应用酶联免疫吸附试验(ELISA)对病例组及对照组患者进行血清炎症因子YKL40浓度的测定。统计学数据分析均采用SPSS19.0软件完成,而经Bonferroni法校正后的检验水准α’=α/4=0.0125,其他检验水准α均为双侧0.05。结果:1.研究对象共80例,此中男性40例,女性40例,平均年龄为(73.03±8.71)岁;四组在年龄、性别上相匹配(P age=0.704;P sex=0.423)。AD组病程为(3.95±2.24)年,发病年龄为(69.65±7.92)岁;AD合并T2DM组中的AD病程为(3.68±3.06)年,发病年龄为(70.60±8.80)岁;T2DM组病程为(13.15±7.21)年,发病年龄为(58.20±7.49)岁;AD合并T2DM组中T2DM的病程为(3.58±3.07)年,发病年龄为(70.80±8.41)岁。2.AD组与AD合并T2DM组在MMSE量表(P=0.407),Mo CA量表(P=0.843),画钟试验(P=0.184)以及AD病程(P=0.755)、AD发病年龄(P=0.722)上相匹配。T2DM组与AD合并T2DM组在T2DM病程(P=0.000)、T2DM发病年龄(P=0.000)上不匹配。3.血清YKL40浓度在AD组为28.04(24.99~34.08)ng/ml,AD合并T2DM组为31.89(24.99~51.56)ng/ml,T2DM组为27.34(19.90~32.63)ng/ml,对照组为19.84(14.50~24.18)ng/ml。4.AD合并T2DM组与AD组之间血清YKL40浓度差异无统计学意义(P=0.0880.0125);T2DM组与对照组之间血清YKL40浓度差异有统计学意义(P=0.0070.0125),T2DM组血清YKL40浓度水平明显高于对照组;AD合并T2DM组与T2DM组之间血清YKL40浓度差异无统计学意义(P=0.0420.0125);AD组与对照组之间血清YKL40浓度差异有统计学意义(P=0.0020.0125),AD组血清YKL40浓度水平明显高于对照组。5.血清YKL40浓度与AD组和AD合并T2DM组MMSE量表总分,Mo CA量表总分,画钟试验以及病程、发病年龄均无明显相关性(P值分别为0.989,0.811,0.825,0.580,0.317)。结论:1.AD患者血清YKL40浓度较正常健康人明显升高,T2DM患者血清YKL40浓度较正常健康人明显升高,AD与T2DM两病共病患者血清YKL40浓度较正常健康人明显升高。2.AD与T2DM两病共病患者血清YKL40浓度较单纯AD患者无明显变化,AD与T2DM两病共病患者血清YKL40浓度较单纯T2DM患者无明显变化。3.血清YKL40浓度与AD患者MMSE量表评分,Mo CA量表评分,画钟试验以及病程、发病年龄均无明显相关性。
[Abstract]:Objective: Alzheimer 's disease (AD) is a progressive development of the central nervous system degenerative disease characterized by cognitive dysfunction and behavioral changes, which occur in the elderly and prophase. The clinical manifestations are memory impairment, time and space orientation decline, speech disorder, computational power decline, visual space function and implementation. The main characteristics of.2 type diabetes (type 2 diabetes mellitus, T2DM) are abnormal blood glucose level and insulin resistance, which are caused by deficiency of insulin and (or) function deficiency, and the prevalence rate is not healthy with the aging of the population. Dietary habits and lack of exercise are increasing rapidly. Although AD and T2DM are two relatively independent diseases, there is evidence that these two diseases have a close pathophysiological link. Studies have shown that T2DM, as an independent risk score for cognitive impairment, can promote the development of AD. The level of serum inflammatory factor YKL40 is elevated in AD and is also elevated in T2DM. This article aims to explore the expression level of inflammatory factor YKL40 in AD with T2DM and to provide clues for the potential mechanism of T2DM and AD co disease. Method: in this study, the case group was hospitalized at Dalian Medical University for 2014-2016 years. A total of 60 patients in a hospital, of which 20 were AD patients (group AD), 20 patients with AD with T2DM (AD combined with T2DM), and 20 (T2DM) patients in T2DM patients were diagnosed with the revised NINCDS-ADRDA diagnostic standard in 2011, and the diagnosis of T2DM group was accepted by the international WHO diabetes expert committee (1999). 20 normal control patients (control group) were qualified for physical examination at the medical center of the First Affiliated Hospital of Dalian Medical University. The cognitive function of all the patients were evaluated by the simple mental condition Checklist (MMSE), the Montreal cognitive assessment scale (Mo CA) and the painting clock test (CDT) before the experiment. An enzyme linked immunosorbent assay (ELISA) was used to determine the concentration of serum inflammatory factor YKL40 in the case group and the control group. The statistical analysis was performed by SPSS19.0 software, and the test level after the Bonferroni correction was alpha '= /4=0.0125, and the other test levels were both bilateral 0.05. results: 1. subjects were 80 cases. There were 40 males and 40 females with an average age of (73.03 + 8.71) years. The four groups were in age and sex (P age=0.704; P sex=0.423) in group.AD. The course of disease was (3.95 + 2.24) years, the age of onset was (69.65 + 7.92) years, AD in AD combined with T2DM group was (3.68 + 3.06) years, the age of onset was (70.60 + 8.80) years, and the disease course of T2DM group was (13.15 + 3.95) years, onset of disease. The course of age was (58.20 + 7.49) years, and the course of T2DM in AD combined with T2DM was (3.58 + 3.07) years, the age of onset was (70.80 + 8.41) years old and AD combined T2DM in MMSE scale (P=0.407), Mo CA scale (P=0.843), clock test (P=0.184) and the course of illness. 0) the concentration of.3. serum YKL40 in T2DM onset age (P=0.000) was 28.04 (24.99~34.08) ng/ml in AD group, 31.89 (24.99~51.56) ng/ml in AD combined with T2DM, 27.34 in T2DM group and 19.84 in control group. There was significant difference in serum YKL40 concentration between group T2DM and control group (P=0.0070.0125), and the level of serum YKL40 concentration in group T2DM was significantly higher than that of control group. There was no significant difference in serum YKL40 concentration between AD combined with T2DM group and T2DM group (P=0.0420.0125), and there was a significant difference between AD group and control group. 5) the level of serum YKL40 in AD group was significantly higher than that of.5. serum YKL40 concentration in the control group and the total score of MMSE scale of group AD and AD with T2DM group, the total score of Mo CA scale, the clock test and the course of disease, and the age of onset was not significantly correlated (P is 0.989,0.811,0.825,0.580,0.317). The serum concentration of YKL40 in T2DM patients was significantly higher than that of normal healthy people. The serum YKL40 concentration of patients with common disease in AD and T2DM two disease patients was significantly higher than that of normal healthy people. The serum YKL40 concentration in patients with.2.AD and T2DM two disease was not significantly changed, and there was no significant change in the serum YKL40 concentration of AD and T2DM two disease patients. There was no significant correlation between serum YKL40 concentration and AD MMSE scale score, Mo CA scale score, clock drawing test, course of disease and age of onset.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.16;R587.1

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