[1]宋晓贇,杨改清,徐志强,等.血清25-羟维生素D3水平与帕金森病患者脑小血管病的相关性[J].新乡医学院学报,2023,40(1):029-34.[doi:10.7683/xxyxyxb.2023.01.005]
　SONG Xiaoyun,YANG Gaiqing,XU Zhiqiang,et al.Correlation between serum 25-hydroxyvitamin D3 level and cerebral small-vessel disease in patients with Parkinson′s disease[J].Journal of Xinxiang Medical University,2023,40(1):029-34.[doi:10.7683/xxyxyxb.2023.01.005]
点击复制

血清25-羟维生素D3水平与帕金森病患者脑小血管病的相关性
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年1期
页码:
029-34
栏目:
临床研究
出版日期:
2023-01-05

文章信息/Info

Title:
Correlation between serum 25-hydroxyvitamin D3 level and cerebral small-vessel disease in patients with Parkinson′s disease
作者:
宋晓贇1; 2; 杨改清2; 徐志强2; 胡琼琼2; 陈赛男2; 胥丽霞2; 贺彩红2; 张东亚2
(1.新乡医学院，河南　新乡　453003;2.郑州大学附属郑州中心医院神经内科，河南　郑州　450002）
Author(s):
SONG Xiaoyun1; 2; YANG Gaiqing2; XU Zhiqiang2; HU Qiongqiong2; CHEN Sainan2; XU Lixia2; HE Caihong2; ZHANG Dongya2
(1.Xinxiang Medical University，Xinxiang 453003，Henan Province，China;2.Department of Neurology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450002,Henan Province,China)
关键词:
帕金森病; 脑小血管病; 25-羟维生素D3
Keywords:
Parkinson′s disease; cerebral small-vessel disease; 25-hydroxyvitamin D3
分类号:
R742.5
DOI:
10.7683/xxyxyxb.2023.01.005
文献标志码:
A
摘要:
目的　探讨血清25-羟维生素D3［25-(OH)D3 ］水平与帕金森病（PD）患者脑小血管病（CSVD）的相关性。方法　选择2017年6月至2021年12月于郑州大学附属郑州中心医院神经内科就诊的203例PD患者为PD组，另选择50例同期在本院进行健康体检的健康人群为对照组。比较PD组与对照组受试者血清25-(OH)D3水平。根据头颅磁共振显像结果，将PD患者分为PD伴CSVD组（n=117）和PD不伴CSVD组（n=86）。比较PD伴CSVD组与PD不伴CSVD组患者的性别、年龄、体质量指数（BMI）、糖尿病病史比例、高血压病史比例、高脂血症比例、吸烟者比例、白细胞计数（WBC）、红细胞计数（RBC）、血小板（PLT）计数及总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、三酰甘油（TG）、糖化血红蛋白（HbA1C）、同型半胱氨酸（Hcy）、胱抑素C（Cys-C）、25-(OH)D3、尿酸（UA）、C反应蛋白（CRP）水平，采用logistic回归分析影响PD伴CSVD的相关因素，采用受试者操作特征（ROC）曲线评估血清25-(OH)D3水平对PD伴CSVD的预测价值。结果　PD组患者的血清25-(OH)D3水平显著低于对照组（Z=-9.965，P<0.05）。PD不伴CSVD组和PD伴CSVD组患者的年龄、糖尿病病史比例、BMI、WBC、RBC及PLT、TC、HbA1C、UA、TG、Hcy、CRP水平比较差异均无统计学意义（P>0.05）；PD伴CSVD组患者的性别、高血压病史比例、高脂血症史比例、吸烟者比例及血清LDL-C、Cys-C水平显著高于PD不伴CSVD组（P<0.05），血清HDL-C、25-(OH)D3水平显著低于PD不伴CSVD组（P<0.05）。单因素logistic回归分析结果显示，男性、高血压病史、高脂血症、吸烟、LDL-C、HDL-C、Cys-C、25-(OH)D3与PD伴发CSVD相关（OR=2.184、2.920、1.928、2.049、1.895、0.346、9.229、0.854，P<0.05）。多因素logistic回归分析结果显示，男性、高血压病史、吸烟、LDL-C为PD患者伴发CSVD的危险因素（OR=2.290、2.556、2.003、1.667，P<0.05），25-(OH)D3为PD患者伴发CSVD的保护因素（OR=0.862，P<0.05）。血清 25-(OH)D3预测PD伴发CSVD 的ROC曲线下面积为0.721(95%置信区间：0.651～0.791，P<0.05)，灵敏度和特异度分别为59.8%和77.9%。结论　低水平血清25-(OH)D3是PD患者伴发CSVD的独立危险因素，血清25-(OH)D3水平对 PD患者伴CSVD具有一定的预测价值。
Abstract:
Objective　To explore the correlation between serum 25-hydroxyvitamin D3 ［25-(OH)D3］ level and cerebral small-vessel disease(CSVD) in patients with Parkinson′s disease(PD) .Methods　A total of 203 patients with PD admitted to the Department of Neurology,Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2017 to December 2021 were selected as PD group,and 50 health people in our hospital in the same period were selected as control group.The serum 25-(OH) D3 level of the subjects between the PD group and the control group was compared.According to the results of brain magnetic resonance imaging,the PD patients were divided into PD with CSVD group (n=117) and PD without CSVD group(n=86).The sex,age,body mass index (BMI),proportion of diabetes history,proportion of hypertension history,proportion of hyperlipidemia,proportion of smoker，white blood cell count (WBC),red blood cell count (RBC),platelet (PLT) count and the total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),triacylglycerol(TG),glycosylated hemoglobin(HbA1C),homocysteine(Hcy),cystatin C(Cys-C),25-(OH)D3,uric acid(UA) and C-reactive protein (CRP) levels of patients were compared between PD with CSVD group and PD without CSVD group;the correlation factors of PD with CSVD were analyzed by logistic regression,the predictive value of serum 25-(OH)D3 level for PD combined with CSVD was evaluated by receiver operating characteristic (ROC) curve.Results　The level of serum 25-(OH)D3 of patients in the PD group was significantly lower than that in the control group (Z=-9.965,P<0.05).There was no significant difference in age,proportion of diabetes history,BMI,WBC,RBC,PLT,TC,HbA1C,UA,TG,Hcy,CRP of patients between the PD without CSVD group and PD with CSVD group (P>0.05);the sex,proportion of hypertension history,proportion of hyperlipidemia history,proportion of smoker and the levels of serum LDL-C and Cys-C of patients in the PD with CSVD group were significantly higher than those in the PD without CSVD group(P<0.05);and the levels of serum HDL-C and 25-(OH)D3 were significantly lower than those in the PD without CSVD group(P<0.05).Univariate logistic regression analysis showed that male,hypertension history,hyperlipidemia,smoking,LDL-C,HDL-C,Cys-C,25-(OH)D3 were correlated with PD combined with CSVD(OR=2.184,2.920,1.928,2.049,1.895,0.346,9.229,0.854;P<0.05).Multivariate logistic regression analysis showed that male,hypertension history,smoking and LDL-C were the risk factors for PD patients combined with CSVD (OR=2.290,2.556,2.003,1.667;P<0.05);and 25-(OH)D3 was the protective factor for PD combined with CSVD(OR=0.862,P<0.05).The area under the curve of ROC of serum 25-(OH)D3 in predicting PD combined with CSVD was 0.721 (95% confidence interval:0.651-0.791,P<0.05),the sensitivity and specificity were 59.8% and 77.9%,respectively.Conclusion　Lower serum 25-(OH)D3 level is an independent risk factor for PD combined with CSVD,and serum 25-(OH)D3 level has certain predictive value for PD combined with CSVD.

参考文献/References:

［1］　LUQUIN M R,KULISEVSKY J,MARTINEZ-MARTIN P,et al.Consensus on the definition of advanced Parkinson′s disease:a neurologists-based delphi study (CEPA study)［J］.Parkinsons Dis,2017,2017:4047392.
［2］　SONG I U,LEE J E,KWON D Y,et al.Parkinson′s disease might increase the risk of cerebral ischemic lesions［J］.Int J Med Sci,2017,14(4):319-322.
［3］　MA X,LI S,LI C,et al.Total cerebral small vessel score association with Hoehn and Yahr stage in Parkinson′s disease［J］.Front Aging Neurosci,2021,13:682776.
［4］　CHEN H,ZHANG M,LIU G,et al.Effect of small vessel disease burden and lacunes on gait/ posture impairment in Parkinson′s disease［J］.Neurol Sci,2020,41(12):3617-3624.
［5］　WANG Y,ZHU J,DELUCA H F.Where is the vitamin D receptor?［J］.Arch Biochem Biophys,2012,523(1):123-133.
［6］　SUPRIYA M,CHANDRA S R,PRABHAKAR P,et al.Vitamin D receptor (VDR) gene polymorphism and vascular dementia due to cerebral small vessel disease in an Asian Indian cohort［J］.J Neurol Sci,2018,391:84-89.
［7］　MOGHADDASI M,MAMARABADI M,AGHAII M.Serum 25-hydroxyvitamin D3 concentration in Iranian patients with Parkinson′s disease［J］.Iran J Neurol,2013,12(2):56-59.
［8］　LV Z,QI H,WANG L,et al.Vitamin D status and Parkinson′s disease:a systematic review and meta-analysis［J］.Neurol Sci,2014,35(11):1723-1730.
［9］　王丽君,郭永涛,尚进,等.帕金森病患者血尿酸和25-羟维生素D3水平的观察研究［J］.中华老年心脑血管病杂志,2017,19(8):806-808.
WANG L J,GUO Y T,SHANG J,et al.Serum uric acid and 25-hydroxyl vitamin D3 levels in Parkinson′s disease patients［J］.Chin J Ceristr Heart Brain Vessel Dis,2017,19(8):806-808.
［10］　王武华,龙翔,胡凌.帕金森病患者髋部骨密度、25-羟维生素D3与髋部骨折的相关性分析［J］.中国骨质疏松杂志,2017,23(11):1476-1479.
WANG W H,LONG X,HU L.The correlation among hip bone mineral density,25-hydroxyl vitamin D3,and hip fracture in patients with Parkinson′s disease［J］.Chin J Osteoporos,2017,23(11):1476-1479.
［11］　BUELL J S,DAWSON-HUGHES B,SCOTT T M,et al.25-hydroxyvitamin D,dementia,and cerebrovascular pathology in elders receiving home services［J］.Neurology,2010,74(1):18-26.
［12］　CHUNG P W,PARK K Y,KIM J M,et al.25-hydroxyvitamin D status is associated with chronic cerebral small vessel disease［J］.Stroke,2015,46(1):248-251.
［13］　吕杰,黄红伟,吴丽娟,等.血清25-羟维生素D水平和腔隙性梗死患者血管周围间隙扩大的相关性［J］.国际脑血管病杂志,2018,26(2):124-130.
LYU J,HUANG H W,WU L J,et al.Correlation between serum 25-hydroxyvitamin D level and enlarged perivascular space in patients with lacunar infarction［J］.Int J Cerebrovasc Dis,2018,26(2):124-130.
［14］　马宁,边瓯,闫思蒙,等.血清25-羟基维生素D水平与老年脑小血管病变相关性研究［J］.临床军医杂志,2019,47(4):345-347.
MA N,BIAN O,YAN S M,et al.Correlation between serum 25-hydroxyvitamin D level and small vessel disease in elderly patients［J］.Chin J Med Offic,2019,47(4):345-347.
［15］　FENG C,TANG N,HUANG H,et al.25-hydroxy vitamin D level is associated with total MRI burden of cerebral small vessel disease in ischemic stroke patients［J］.Int J Neurosci,2019,129(1):49-54.
［16］　中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑小血管病诊治共识［J］.中华神经科杂志,2015,48(10):838-844.
NEUROLOGY BRANCH OF CHINESE MEDICAL ASSOCIATION,CEREBROVASCULAR DISEASE GROUP,NEUROLOGICAL BRANCH OF CHINESE MEDICAL ASSOCIATION.Chinese consensus on diagnosis and treatment of cerebral small vessel disease［J］.Chin J Neurol,2015,48(10):838-844.
［17］　LI G,MA J,CUI S,et al.Parkinson′s disease in China:a forty-year growing track of bedside work［J］.Transl Neurodegener,2019,8:22.
［18］　CHEN H,WAN H,ZHANG M,et al.Cerebral small vessel disease may worsen motor function,cognition,and mood in Parkinson′s disease［J］.Parkinsonism Relat Disord,2021,83:86-92.
［19］　LEE J Y,KIM J S,JANG W,et al.Association between white matter lesions and non-motor symptoms in Parkinson disease［J］.Neurodegener Dis,2018,18(2-3):127-132.
［20］　CHEN H,ZHANG M,LIU G,et al.Effect of small vessel disease burden and lacunes on gait/posture impairment in Parkinson′s disease［J］.Neurol Sci,2020,41(12):3617-3624.
［21］　NEZU T,HOSOMI N,AOKI S,et al.Endothelial dysfunction is associated with the severity of cerebral small vessel disease［J］.Hypertens Res,2015,38(4):291-297.
［22］　BALDEN R,SELVAMANI A,SOHRABJI F.Vitamin D deficiency exacerbates experimental stroke injury and dysregulates ischemia-induced inflammation in adult rats［J］.Endocrinology,2012,153(5):2420-2435.
［23］　RIMONDI E,MARCUZZI A,CASCIANO F,et al.Role of vitamin D in the pathogenesis of atheromatosis［J］.Nutr Metab Cardiovasc Dis,2021,31(1):344-353.

相似文献/References:

[1]马琪林,鲁丛霞,蔡琰,等.帕金森病患者血小板线粒体谷氨酸载体和复合物活性研究 [J].新乡医学院学报,2007,24(02):114.
[2]洪丽,李珂,闫晓海,等.瞬目反射与肛门括约肌肌电图对帕金森病患者病情分期判定的意义[J].新乡医学院学报,2012,29(12):936.
[3]朱丰霞,常海敏,段 瑛,等.人参皂苷 Rg1对帕金森病小鼠黑质中酪氨酸羟化酶及ephrinB2和磷酸化 c-Jun表达的影响[J].新乡医学院学报,2014,31(10):781.[doi:10.7683/xxyxyxb.2014.10.003]
[4]魏家彬,杨　帆,王淑秀.人参皂苷Ｒｇ１对１甲基４苯基１，２，３，６四氢吡啶诱导的帕金森病小鼠黑质酪氨酸蛋白激酶Ａ４表达的影响[J].新乡医学院学报,2015,32(05):404.
[5]李　乐,黄志勇,贺文麟.血浆同型半胱氨酸、催乳素水平与帕金森病及帕金森病痴呆相关性分析[J].新乡医学院学报,2015,32(05):438.
[6]宋金辉,王普清,丁旭东,等.节律性视觉刺激对帕金森病患者运动功能及平衡能力的影响[J].新乡医学院学报,2014,31(12):1006.[doi:10.7683/xxyxyxb.2014.12.011]
[7]孙　冰,徐玉英.氧化苦参碱对帕金森小鼠中枢神经系统氧化应激的影响[J].新乡医学院学报,2020,37(6):509.[doi:10.7683/xxyxyxb.2020.06.002]
　SUN Bing,XU Yuying.Effects of oxymatrine on oxidative stress of central nervous system in Parkinson mice[J].Journal of Xinxiang Medical University,2020,37(1):509.[doi:10.7683/xxyxyxb.2020.06.002]
[8]王旭生,朱欣茹,穆俊林,等.事件相关电位P300和血清神经元PAS结构域蛋白4水平与脑小血管病患者认知障碍的相关性[J].新乡医学院学报,2020,37(4):351.[doi:10.7683/xxyxyxb.2020.04.011]
　WANG Xusheng,ZHU Xinru,MU Junlin,et al.Study on the relationship between event-related potential P300,serum neuron PAS domain protein 4 level and cognitive disorder in patients with cerebral small vessel disease[J].Journal of Xinxiang Medical University,2020,37(1):351.[doi:10.7683/xxyxyxb.2020.04.011]
[9]张静怡,邓永宁,张　萌,等.Sirt3基因过表达慢病毒载体的构建及其在人神经母细胞瘤SH-SY5Y细胞中的表达[J].新乡医学院学报,2021,38(1):006.[doi:10.7683/xxyxyxb.2021.01.002]
　ZHANG Jingyi,DENG Yongning,ZHANG Meng,et al.Construction of lentiviral vector with Sirt3 gene overexpression and its expression in human neuroblastoma SH-SY5Y cells[J].Journal of Xinxiang Medical University,2021,38(1):006.[doi:10.7683/xxyxyxb.2021.01.002]
[10]汤丹丹,张　勋,符益纲,等.磁共振波谱在原发性帕金森病治疗效果评估中的应用价值[J].新乡医学院学报,2021,38(8):734.[doi:10.7683/xxyxyxb.2021.08.007]
　TANG Dandan,ZHANG Xun,FU Yigang,et al.Value of magnetic resonance spectroscopy in evaluating the therapeutic effect of primary Parkinson′s disease[J].Journal of Xinxiang Medical University,2021,38(1):734.[doi:10.7683/xxyxyxb.2021.08.007]

更新日期/Last Update: 2023-01-05