认知障碍程度分层的阿尔茨海默病和血管性痴呆患者标准和新型脂质参数的差异

Asija Zaciragic, Amela Dervisevic, Amina Valjevac, Almir Fajkic, Selma Spahic, Ilvana Hasanbegovic, Radivoj Jadric, Orhan Lepara
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引用次数: 1

摘要

背景:脂质和脂蛋白显著参与维持人脑和神经元的结构和功能成分,但它们在阿尔茨海默病(AD)和血管性痴呆(VD)发展中的作用尚不清楚。目的:本研究的目的是探讨AD和VD患者标准和新型血脂参数的差异,并按认知障碍程度(CI)分层。方法:本研究纳入66例AD患者、50例VD患者和60例对照组。为了评估全球认知功能,蒙特利尔认知评估(MoCA)测试被使用。为了区分VD患者和AD患者,采用Hachinski缺血评分。血浆总胆固醇(TC)、高密度脂蛋白-胆固醇(HDL-C)和甘油三酯(TG)水平采用标准酶比色技术测定,而低密度脂蛋白-胆固醇(LDL-C)水平采用弗里德瓦尔德公式计算。分别计算非传统脂质指标TG/HDL-C、TC/HDL-C、LDL-C/HDL-C比值。组间差异采用Kruskal Wallis检验和Mann-Whitney检验或方差分析和Tuckey事后检验进行分析。结果:本研究发现,中度CI的AD组和重度CI的AD组患者血清TC、TG、LDL-C、VLDL-C、Non- HDL-C、动脉粥样硬化指数、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C水平均明显低于认知正常对照组。此外,与对照组相比,重度和中度CI的VD组患者TG水平显著降低。我们的研究结果还显示,中度CI的AD组患者的TC、TG、LDL-C、Non-HDL-C、动脉粥样硬化指数、TG/HDL-C、TC/HDL-C水平明显低于中度CI的VD患者。此外,AD组合并严重CI患者TC、LDL-C、Non-HDL-C及TC/HDL-C水平均明显低于VD合并严重CI患者。结论:本研究结果显示不同CI程度的AD和VD患者存在脂质代谢失调。在中度和重度CI中,与VD患者相比,AD患者的大多数标准和新型脂质参数水平都较低。需要进一步更大规模的前瞻性研究来阐明标准和新型脂质参数在评估AD和VD不同程度CI时的准确性。
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Difference in the Standard and Novel Lipid Profile Parameters Between Patients With Alzheimer's Disease and Vascular Dementia Stratified by the Degree of Cognitive Impairment.

Background: Lipids and lipoproteins are significantly involved in maintaining structural and functional components of the human brain and neurons, but their role in the development of Alzheimer's disease (AD) and vascular dementia (VD) remains unclear.

Objective: The aim of the present study was to explore the differences in the standard and novel lipid profile parameters in patients with AD and VD, stratified by the degree of cognitive impairment (CI).

Methods: Present study included 66 patients with AD, 50 patients with VD, and 60 control subjects. For an evaluation of the global cognitive function the Montreal Cognitive Assessment (MoCA) test was used. In order to distinguish patients with VD from those with AD the Hachinski ischemic score was used. Plasma total cholesterol (TC), high-density lipoprotein -cholesterol (HDL-C), and triglycerides (TG) levels were determined using standard enzymatic colorimetric techniques, whereas the Friedewald formula was used to calculate low-density lipoprotein-cholesterol (LDL-C) levels. The non-traditional lipid indices such as TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C ratio were separately calculated. The differences between the groups were analyzed with the Kruskal Wallis test followed by the Mann-Whitney test or with ANOVA followed by the Tuckey posthoc test.

Results: Results of the conducted study have found that the patients in AD group with moderate CI and patients in AD group with severe CI exhibited significantly lower levels of serum TC, TG, LDL-C, VLDL-C, Non- HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C and LDL-C/HDL-C compared to cognitively normal control subjects. Moreover, patients in VD group with severe and moderate CI had significantly lower level of TG compared to control group of subjects. Our results have also shown that patients in AD group with moderate CI had significantly lower level of TC, TG, LDL-C, Non-HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C compared to VD patients with moderate CI. In addition, patients in AD group with severe CI had significantly lower level of TC, LDL-C, Non-HDL-C and TC/HDL-C compared to VD patients with severe CI.

Conclusion: The results of this study have shown dysregulation of lipid metabolism in AD and VD patients with different degree of CI. In both moderate and in severe CI, patients with AD had lower levels of majority of standard and novel lipid parameters compared to patients with VD. Further larger prospective studies are required to elucidate the accuracy of standard and novel lipid parameters in the assessment of different degree of CI in AD and VD.

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