| Objective: Through the detection of Alzheimer's disease(AD)and Vascular dementia(VaD)patients in serum of advanced glycation end products(AGEs)and soluble receptor for advanced glycation end products(sRAGE)levels to explore their relationship with AD and VaD and to investigate the possible risk factors of AD and VaD and finally to provide the basis for early diagnosis and prevention.Method: To collect 149 patients from the Department of Neurology in The Second Hospital of Lanzhou University from February 2017 to January 2018.Through the MMSE score and the corresponding inclusion exclusion criterias divide the patients into different groups,including Vascular dementia group(n=64),non dementia of cerebral infarction group(n=51),Alzheimer disease group(n=34)and there were 31 patients had no differences in sex,age and educational level were selected for health check-up in the control group.The general data of all the participants were recorded,the general information and MMSE score,serum AGEs,sRAGE levels and homocysteine(Hcy),uric acid(UA)and lipids levels were compared among four groups.At the same time to compare the differences between different indices in different groups,then analyze their correlations with pathogenesis.Results: 1.The basic data of vascular dementia group,Alzheimer's disease group,non dementia of cerebral infarction group and normal control group were compared: four groups had no significant differences in sex,age,smoking,alcohol consumption and diabetes(p>0.05).The MMSE score of AD group and VaD group were significantly lower than those of N-VaD group and normal control group(P<0.05),and showed significant differences between them;There were no obvious differences in MMSE score between N-VaD group and normal control group(P>0.05).The incidence of hypertension in group AD,group VaD and group N-VaD were all higher than that in normal control group,and there were significant differences(P<0.05);The incidence of hypertension in VaD group was higher than that of AD group and had significant differences(P<0.05),but there were no obvious differences between VaD group and N-VaD hypertension group.2.Comparison of the levels of serum AGEs,sRAGE and Hcy,UA,TC,TG,HDL-C,LDL-C between the AD groups,the VaD group,the N-VaD group and the normal control group showed that: between the four groups there were statistical significance differences in serum AGEs levels(P<0.05).Comparison between the two groups in each,we could find AGEs levels of AD group was higher than those of VaD group and normal control group and showed significant differences(P<0.05);AGEs levels of N-VaD group were higher than those of VaD group and normal control group,showed significant differences(P<0.05);There were no significant differences in AGEs levels between AD group and N-VaD group(P>0.05)as well as VaD group and normal control group(P>0.05).The differences of Hcy leves between the four groups were statistically significant.Comparison between every two groups in it: the levels of Hcy in VaD group were higher than that of the normal control group and with significant difference(P<0.05);Hcy in AD group was higher than that of the normal control group and there were significant differences between them(P<0.05);The Hcy levels were no significant difference between AD group and VaD group(P>0.05).Compared the levels of UA,TC,TG,HDL-C,LDL-C between the four groups,there were no significant differences(P>0.05).3.The analysis of the receiver operating characteristic curve(ROC curve)showed that the ROC curve of serum AGEs in the diagnosis of AD,AUC 0.617,P<0.05,95%CI 0.510-0.725,and serum AGEs has low diagnostic value for AD,the critical value of serum AGEs in the diagnosis of AD was 541.1364,the corresponding diagnostic sensitivity was 50% and the specificity was 76%.ROC curve of serum Hcy in the diagnosis of VaD showed that AUC 0.623,P<0.05,95%CI 0.534-0.711 and serum Hcy has low diagnostic value for VaD,the critical value of serum Hcy in the diagnosis of VaD was 29.53,the corresponding diagnostic sensitivity was 37.5% and the specificity was 85.3%.4.Comparing the levels of AGEs,sRAGE,Hcy and UA between different groups of vascular dementia showed that there were no significant differences(p>0.05)between the levels of AGEs,sRAGE,Hcy and UA among different dementia levels.5.Using Spearman rank correlation analysis showed that age(r=-0.168,p<0.05),Hcy(r=-0.242,p<0.05)was negatively correlated with the MMSE score,BMI(r=0.151,p<0.05)correlated with MMSE score;,hypertension,diabetes,smoking,alcohol,TC,TG,HDL-C,LDL-C,AGEs,sRAGE and MMSE were no significant correlation(P>0.05).Conclusions: 1.The serum AGEs may be related to the occurrence and development of AD.2.Hcy may be related to the occurrence and development of AD and VaD.3.AGEs has a lower diagnostic value for AD,and Hcy has a lower diagnostic value for VaD... |
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