阿尔茨海默病患者糖、脂代谢与脂多糖的相关性

doi:10.3969/j.issn.1673-8640.2020.11.010

摘要/Abstract

摘要：

目的探讨阿尔茨海默病（AD）患者糖、脂代谢与脂多糖（LPS）的相关性。方法选取AD性重度痴呆患者38例（痴呆组）、轻度认知障碍（MCI）37例（MCI组）、老年健康体检者40名（正常对照组）,检测血脂[总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、载脂蛋白E（apo E）]、空腹血糖（FPG）、空腹胰岛素（FINS）及肠道屏障功能指标（D-乳酸、LPS）。计算胰岛素抵抗指数（HOMA-IR）。结果痴呆组和MCI组FPG、FINS、HOMA-IR及TC水平均高于正常对照组（P<0.01）,血清HDL-C水平低于正常对照组（P<0.01）。MCI组血清TG水平高于正常对照组（P<0.05）。痴呆组和MCI组之间FPG、FINS、HOMA-IR差异均有统计学意义（P<0.01）。痴呆组血清D-乳酸、LPS水平均高于正常对照组（P<0.000 1）。Pearson相关分析显示,痴呆组LPS与TC呈正相关（r=0.68,P<0.05）。Logistic回归分析结果显示,TC升高、FPG升高是MCI和痴呆发生的危险因素（P<0.05）,HDL-C升高是MCI和痴呆发生的保护因素（P<0.05）,LPS升高是痴呆发生的危险因素（P<0.05）。结论 AD患者糖、脂代谢异常,可能与肠道黏膜屏障受损有一定关系。

关键词: 脂多糖, 血脂, 血糖, 阿尔茨海默病

Abstract:

Objective To analyze the correlation between glycolipid metabolism and lipopolysaccharide（LPS） in patients with Alzheimer's disease（AD）. Methods Blood lipids [total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C） and apolipoprotein E（apo E）],fasting blood glucose（FPG）,fasting insulin（FINS） and gut barrier function indicators（D-lactic acid and LPS） were determined in 38 patients with severe dementia（dementia group）,37 patients with mild cognitive impairment（MCI）（MCI group） and 40 geriatric healthy subjects（healthy control group）. Homeostasis model assessment fo insulin resistance（HOMA-IR） was calculated. Results The FPG,FINS,HOMA-IR and TC levels of dementia group and MCI group were higher than those of healthy control group（P<0.01）,and serum HDL-C level was lower（P<0.01）. Serum TG level in MCI group was higher than that in healthy control group（P<0.05）. The difference of FPG,FINS and HOMA-IR between dementia group and MCI group had statistical significance（P<0.01）. Serum levels of D-lactic acid and LPS in dementia group were higher than those in healthy control group（P<0.000 1）. Pearson correlation analysis showed a positive correlation between LPS and TC in dementia group（r=0.68,P<0.05）. Logistic regression analysis showed that increased TC and FPG were MCI and dementia's risk factors,and increased HDL-C was a protective factor（P<0.05）. Increased LPS was a risk factor for dementia（P<0.05）. Conclusions Abnormal glycolipid metabolism in AD patients may be associated with impaired gut barrier.

Key words: Blood lipid, Blood glucose, Lipopolysaccharide, Alzheimer's disease

中图分类号:

R446.1

李丹, 林萍, 金伟峰, 陈姝子, 李萍, 程训佳. 阿尔茨海默病患者糖、脂代谢与脂多糖的相关性[J]. 检验医学, 2020, 35(11): 1126-1129.

LI Dan, LIN Ping, JIN Weifeng, CHEN Shuzi, LI Ping, CHENG Xunjia. Correlation between glycolipid metabolism and lipopolysaccharide in patients with Alzheimer's disease[J]. Laboratory Medicine, 2020, 35(11): 1126-1129.

图/表 5

参考文献 19

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组别	例数	体重/kg	身高/cm	BMI/（kg/m²）	腹围/cm
痴呆组	38	53.68±8.04	157.00±5.68	21.78±2.67	81.88±10.35
MCI组	37	55.34±9.26	158.00±6.64	22.17±3.35	82.53±10.35
正常对照组	40	54.85 ±8.89	160.00±8.42	21.56±2.12	82.36 ±4.55

组别	例数	体重/kg	身高/cm	BMI/（kg/m²）	腹围/cm
痴呆组	38	53.68±8.04	157.00±5.68	21.78±2.67	81.88±10.35
MCI组	37	55.34±9.26	158.00±6.64	22.17±3.35	82.53±10.35
正常对照组	40	54.85 ±8.89	160.00±8.42	21.56±2.12	82.36 ±4.55

组别	例数	FPG/（mmol/L）	FINS/（pmol/L）	HOMA-IR
痴呆组	38	6.79±1.36^**#	66.80（36.92~99.29）^**#	22.94（10.58~29.56）^**#
MCI组	37	7.66±1.85^**	54.96（34.08~83.10）^**	15.08（7.62~18.04）^**
正常对照组	40	5.99±1.22	42.96（28.91~65.32）	11.08（7.62~18.04）
组别	TC/（mmol/L）	TG/（mmol/L）	HDL-C/（mmol/L）	apo E/（mmol/L）
痴呆组	5.27±0.95^**	1.75±0.90	1.09±0.28^**	4.63±1.21
MCI组	5.48±1.04^**	1.93±0.85^*	0.95±0.57^**	4.68±1.35
正常对照组	4.48±0.86	1.39±0.78	1.29±0.34	4.16±0.81

组别	例数	FPG/（mmol/L）	FINS/（pmol/L）	HOMA-IR
痴呆组	38	6.79±1.36^**#	66.80（36.92~99.29）^**#	22.94（10.58~29.56）^**#
MCI组	37	7.66±1.85^**	54.96（34.08~83.10）^**	15.08（7.62~18.04）^**
正常对照组	40	5.99±1.22	42.96（28.91~65.32）	11.08（7.62~18.04）
组别	TC/（mmol/L）	TG/（mmol/L）	HDL-C/（mmol/L）	apo E/（mmol/L）
痴呆组	5.27±0.95^**	1.75±0.90	1.09±0.28^**	4.63±1.21
MCI组	5.48±1.04^**	1.93±0.85^*	0.95±0.57^**	4.68±1.35
正常对照组	4.48±0.86	1.39±0.78	1.29±0.34	4.16±0.81

组别	例数	D-乳酸/（mg/L）	LPS/（U/L）
痴呆组	38	23.95±7.03^*	17.35±6.62^*
正常对照组	40	16.25±6.87	9.45±2.94