Study On The Correlation Between Serum IDE,IGF-1,APOE-4 Levels And Parkinson’s Disease And Its Severity

Objective:To study the correlation between Parkinson’s disease(PD)and serum levels of insulin-degrading enzyme(IDE),insulin-like growth factors-1(IGF-1)and apolipoprotein E-4(APOE-4),and to find out the possible factors influencing the progression of PD.Methods:From December 2019 to November 2020,70 PD patients in our hospital were included as PD group,and 85 healthy people in the same period were included in the control group.First,in the PD group,PD patients were divided into two subgroups according to the revised Hoehn Yahr(H-Y)scale,the Part V of Unified Parkinson’s Disease Rating Scale(UPDRS)Version 3.0.The patients with H-Y grading of 1-2 were divided into early stage PD group,and the patients with H-Y grading of 2.5-5 were divided into middle-late stage PD group.Secondly,UPDRS Parts Ⅰ,Ⅱ,Ⅲ,Ⅳand VI were used to evaluate the symptoms of PD patients in the two subgroups.The data of age,gender,smoking history,drinking history,body mass index(BMI)and the course of PD were collected,and the fasting serum levels of IDE,IGF-1 and APOE-4 were detected by enzyme-linked immunosorbent assay,SPSS 23.0 was used to compare the differences of serum levels of IDE,IGF-1 and APOE-4 among the control group,PD group and PD subgroups,The pair correlation between serum IDE,IGF-1 and APOE-4 levels in PD group was analyzed-In addition,the correlation between serum IDE,IGF-1 and APOE-4 levels and age,gender,smoking,drinking,BMI,course of disease and UPDRS scores in PD group was further analyzed.Results:1.Serum IDE level:the serum IDE level in PD group was(7.63±4.13)ng/mL,and the serum IDE level in control group was(10.89±5.35)ng/mL.The serum IDE level in PD group was significantly lower that of control group(P<0.001).The serum IDE level in early stage PD group was(8.82±3.99)ng/mL,which was significantly higher than that of(5.84±3.72)ng/mL in the middle-late stage PD group(P=0.034).Serum IDE levels in early stage PD group and middle-late stage PD group were lower than those in control group,and the differences were statistically significant(P=0.048 and P<0.001,respectively).2.Serum IGF-1 level:the serum IGF-1 level in PD group was(83.30±42.08)ng/mL,and it was(65.10±34.67)ng/mL in control group.The serum IGF-1 level in PD group was significantly higher than that of control group(P=0.009).The serum IGF-1 level in early stage PD group was(98.37±37.39)ng/mL,which was significantly higher than that of(60.70±38.98)ng/mL in the middle-late stage PD group(P<0.001).The serum IGF-1 level in early stage PD group was significantly higher than that in control group(P<0.001),but there was no significant difference between middle-late stage PD group and control group(P=1.000).3.Serum APEO-4 level:the serum APOE-4 level in PD group was(2.85±1.65)mg/dL,it was(1.53±2.44)mg/dL in control group.The serum APOE-4 level in PD group was significantly higher than that of control group(P<0.001).The serum level of APOE-4 in the early stage PD group was(2.29±l.24)mg/dL,which was significantly lower than that of(3.69±1.83)mg/dL in the middle-late stage PD group(P=0.04).The serum APOE-4 levels in early stage PD group and middle-late stage PD group were significantly higher than those in control group(P<0.001 and P<0.001,respectively).4.Pair correlation of serum IDE,IGF-1 and APOE-4 levels in PD patients:there was a positive correlation between serum IDE level and IGF-1 level in PD group(r=0.403,P=0.001).There was no correlation between serum APOE-4 level and IDE level(P=0.857),and no correlation between serum APOE-4 level and IGF-1 level(P=0.166).5.Correlation of serum IDE,IGF-1 and APOE-4 levels with age,gender,smoking,drinking,BMI and course of disease in PD group:there was no correlation between serum IDE level and age,gender,smoking,drinking,BMI index(P=0.381,0.860.0,313,0.221 and 0.107,respectively),but serum IDE level was negatively correlated with the course of PD disease(r=-0.395,P=0.001).Serum IGF-1 level was negatively correlated with age(P=0.015),but there was no correlation between serum IGF-1 level and gender,smoking,drinking and BMI(P=0.700,0.315,0.513 and 0.488,respectively),Serum IGF-1 level was negatively correlated with the course of PD disease(r=-0.314,P=0.008).There was no correlation between serum APOE-4 level and age,gender,smoking,drinking and BMI(P=0.315,0.924,0.174,0.803,0.377 respectively),but the serum APOE-4 level was positively correlated with the course of PD disease(r=0.330,P=0.005).6.Correlation between serum IDE,IGF-1,APOE-4 levels and UPDRS scores:serum IDE levels were negatively correlated with UPDRS scores of Part Ⅰ,Part Ⅱ,Part Ⅲand Part Ⅴ(H-Y scale)(r=-0.254,-0.294,-0.252 and-0.395,respectively;P=0.034;0.013,0.014 and 0.001,respectively),and there was no correlation between serum IDE levels and the UPDRS scores of Part Ⅳ(r=-0.155,P=0.202).Serum IDE levels were positively correlated with UPDRS scores of Part Ⅵ(r=0.337,P=0.004).The serum IGF-1 level was negatively correlated with UPDRS scores of Part Ⅱ Part Ⅲand Part V(H-Y scale)(r=-0.347,-0.292 and-0.411,respectively;P=-0.003,0.014 and<0.001,respectively),There was a positive correlation between serum IGF-1 level and UPDRS scores of Part VI(r=0.435,P<0.001).There was no correlation serum IGF-1 level and UPDRS scores of Part Ⅰ and Part Ⅳ(r=-0.221 and-0.217;P=0.065 and 0.072,respectively).There was a positive correlation between the serum APOE-4 level and the UPDRS scores of Part Ⅱ,Part Ⅳ and Part Ⅴ(H-Y scale)(r=0.258,0.414 and 0.391,respectively;P=0.031,<0.001 and 0.001,respectively).There was a negative correlation between serum IGF-1 level and UPDRS scores of Part Ⅵ(r=-0.284,P=0.017),but there was no correlation between serum IGF-1 level and UPDRS scores of Part Ⅰand Part Ⅲ(r=0.l01 and 0.224;P=0.406 and 0.062,respectively).Conclusions:1.Compared with the control group,the serum IDE level in PD group decreased significantly,and the serum IDE level in middle-late stage PD group showed a downward trend compared with that of early stage PD group.Serum IDE level was negatively correlated with the severity of PD.2.The serum IGF-1 level in the early stage PD group was higher than that in the control group and the middle late stage PD group.There was no significant difference between middle late stage PD group and control group.In addition,the serum IGF-1 level was negatively correlated with the severity of PD.3.The serum APOE-4 level in PD group was higher than that in control group.The serum APOE-4 level in middle late stage PD group was significantly higher than that in early stage PD group,and the serum APOE-4 level was positively correlated with the severity of PD.4.In PD group,serum IDE level was positively correlated with serum IGF-1 level,while serum APOE-4 level was not correlated with serum IDE and IGF-1 levels.