The Correlation Between Serum YKL40 And Alzheimer's Disease As Well As Type 2 Diabetes Mellitus

Objective: Alzheimer's disease(AD)is a central nervous system degenerative disease characterized by progressive cognitive impairment and behavioral disorders.It happens at old or nearly old age with clinical manifestations including dysmnesia,temporal spatial disorientation,aphasia,computing power damage,visual spatial function and executive ability damage,and apraxia,agnosia,abstract thinking impairment and personality and behavior changes.Type 2 diabetes mellitus(T2DM)is a diseases characterized by hyperglycemia and insulin resistance,due to the secretion insufficient and/or defect of insulin.The morbidity is increasing rapidly and becoming a gradually growing trend with the aging of population,unhealthy diet and lack of exercise.Although AD and T2 DM are two relatively independent diseases,there is evidence that these two diseases are pathophysiologically closely related.Studies have shown that T2 DM as an independent risk factor for cognitive dysfunction,can promote the occurrence and development of AD.Studies have also shown that the level of serum inflammatory factor YKL40 rises in both AD and T2 DM.The aim of this study is to investigate the expression level of serum inflammatory factor YKL40 in AD combination with T2 DM,and to provide clues to the research of potential mechanism of comorbidity of T2 DM and AD.Methods: In this study,a total of 60 patients who were in the First Affiliated Hospital of Dalian Medical University from 2014 to 2016 constitute the case group,in which,there are 20 patients with AD(group AD),20 patients with AD combination with T2DM(group AD combination with T2DM),20 patients with T2DM(group T2DM).The diagnosis of AD patients is in line with the revised NINCDS-ADRDA diagnostic criteria in 2011.The diagnosis of patients with T2 DM is based on the diagnostic criteria presented by the current WHO International Diabetes Expert Committee(1999).there are 20 normal control patients(group control),who were during the same period qualified as health personnel by the First Affiliated Hospital of Dalian Medical University Medical Center,The cognitive function of all enrolled patients is assessed by mini-mental state examination(MMSE),montreal cognitive assessment(Mo CA)and clock drawing test(CDT)before the experiment.Enzyme linked immunosorbent assay(ELISA)is used to measure the concentration of serum inflammatory factor YKL40 in the case group and control group.Statistical analysis is performed with SPSS19.0 software.The calibration level by Bonferroni method is a'=a/4=0.0125 and other test levels are bilateral 0.05.Results: 1.A total of 80 cases are enrolled in this study,including 40 cases of male and 40 cases of female,with an average age is 73.03±8.71.The age and sex of the four groups are matched(P age =0.704;P sex = 0.423).The course of AD group is 3.95±2.24,and onset age is 69.65±7.92.The duration of AD in the AD combination with T2 DM group is 3.68±3.06,and the onset age is 70.60± 8.80.The course of T2 DM group is 13.15±7.21,and the onset age is 58.20±7.49.The duration of T2 DM in the AD combination with T2 DM group is 3.58±3.07,and the onset age is 70.80±8.41.2.Group AD and group AD combination with T2 DM are matched on the MMSE scale(P=0.407),Mo CA scale(P=0.843),CDT(P=0.184)and the duration of AD(P=0.755),the onset age of AD(P=0.722).Group T2 DM and group AD combination with T2 DM in the duration of T2DM(P=0.000),and the onset age of T2DM(P=0.000)does not match.3.Serum YKL40 concentration in AD patients,AD combination with T2 DM patients,T2 DM patients,healthy controls is 28.04(24.99~34.08)ng/ml,31.89(24.99~51.56)ng/ml,27.34(19.90~32.63)ng/ml and 19.84(14.50~24.18)ng/ml respectively.4.There is no significant difference in serum YKL40 concentration between AD combination with T2 DM patients and AD patients(P=0.088>0.0125);There is significant difference in serum YKL40 concentration between T2 DM patients and healthy controls(P=0.007<0.0125),compared with healthy controls,and the level of serum YKL40 concentration is increased significantly in T2 DM patients;There is no significant difference in serum YKL40 concentration between AD combination with T2 DM patients and T2 DM patients(P=0.042>0.0125);There is significant difference in serum YKL40 concentration between AD patients and healthy controls(P=0.002<0.0125),Serum YKL40 concentration is significantly higher in AD than in healthy controls.5.There are no significant correlation between serum YKL40 concentration and the MMSE score(P = 0.989),Mo CA score(P = 0.811),CDT scores(P =0.825)or duration(P = 0.580),onset age(P = 0.317)in group AD and group AD combination with T2 DM.Conclusions: 1.Serum YKL40 concentration is significantly higher in AD than in healthy people;serum YKL40 concentration is significantly higher in T2 DM than in healthy people;serum YKL40 concentration of patients with AD combination with T2 DM is significantly higher than that of healthy people.2.There is no significant difference in serum YKL40 concentration between AD combination with T2 DM patients and AD patients;there is also no significant difference in serum YKL40 concentration between AD combination with T2 DM patients and T2 DM patients.3.There is no significant correlation between serum YKL40 concentration and the MMSE score,Mo CA score,CDT scores or duration and onset age in AD patients.