Changes In Common Blood Indexes In Alzheimer's Disease And Related Diseases

BackgroundAlzheimer's disease?AD?is a neurodegenerative disease that occurs in old age and pre-senile period,and is the most common type of dementia in old age.AD not only causes great pain to patients due to its own and complications,but also brings heavy care and medical burden to society and families.As the population ages,the number of AD patients in China may increase year by year.The exact pathogenesis of AD is still unclear.There are several theories,including?-amyloid?A??theory,tau protein theory,abnormal glucose metabolism theory,lipid metabolism disorder theory,neuroinflammation theory,oxidative stress theory,metal ion disorder theory.In recent years,some achievements have been made in the search for biomarkers of AD's diagnosis and biomarkers of prediction of progression from mild cognitive impairment?MCI?to AD.With the rapid development of large data and artificial intelligence in recent years,their integration with medicine,especially diagnosis and treatment of disease,has become closer and closer,and researches absorbing their concepts and methods have also increased.Based on the above research background,this study compares the common blood indexes of different groups,screens the indexes with differences,and explores the possibility of one index's or combined multiple indexes'becoming biomarkers.PurposeTo provide evidence for known pathophysiological mechanisms;to provide clues for the discovery of new mechanisms?for indexes that are currently not reported or reported less?;to explore the possibility of one index's or combined multiple indexes'becoming biomarkers.MethodsPatients who were admitted to the Department of Neurology,the First Affiliated Hospital of Zhengzhou University from January 2013 to February 2018 and complained of memory loss or other cognitive impairment,were divided into 5groups according to specific diagnostic criteria,with 1 normal control group.Collect and organize their common blood index data and scale score data during hospitalization and enter them into the computer.Explore the correlation between the cognitive scores of patients in the AD group and the indexes,compare whether there are differences in common blood indicators among different groups?further comparisons are done in indexes with differences?,and explore whether the indexes with differences can be combined to meet the basic requirements of blood markers.Results1.Analysis in AD group:With mini-mental state examination?MMSE?score as the dependent variable,red blood cell distribution width,glutamyl transpeptide enzyme,albumin and low density lipoprotein-cholesterol entered the linear regression model;with Montreal cognitive assessment?MoCA?score as the dependent variable,red blood cell distribution width and number of monocytes entered the linear regression model.2.Comparisons of indexes in AD group,dementia with Lewy body?DLB?group,frontotemporal dementia?FTD?group and normal control?NC?group:lymphocyte number,basophil number,high density lipoprotein-cholesterol,prothrombin time,D-dimer were different in the comparison of multiple groups;in addition to the number of basophils,some significant differences were also found in the comparisons between two groups.3.Comparisons of indexes in AD group,vascular dementia?VaD?group,NC group:globulin,glucose,total cholesterol,high density lipoprotein-cholesterol,prothrombin time were different in the comparison of multiple groups;in addition to globulin,some significant differences were also found in the comparisons between two groups.4.Comparisons of indexes in AD group,MCI group and NC group:Alkaline phosphatase,high density lipoprotein-cholesterol and prothrombin time were different in multi-group comparisons.Some significant differences were also found in the comparisons between two groups.5.In the indexes with less sample size,?₂-microglobulin,cystatin C,apolipoprotein A?,and C-reactive protein also showed significant differences in some comparisons between two groups.6.Using logistic regression to combine multiple indicators,we obtained a total of 7 statistically significant receiver operating characteristic curves?ROC?,of which3 contained a point where sensitivity and specificity were greater than 0.80 at the same time.ConclusionCommon blood indexes?such as lymphocyte number,alkaline phosphatase,glucose,total cholesterol,high density lipoprotein-cholesterol,prothrombin time,D-dimer?differ between different types of cognitive impairment groups and between cognitive impairment groups and the normal group.Most of differences are consistent with known pathogenesis;some indexes?such as?₂-microglobulin,cystatin C?are worthy of further study.The combination of multiple blood indexes has a certain effect on differential diagnosis,whereas it can seldom meet the basic requirement for biomarkers.It has limited clinical application,yet it is worth expanding the sample size for further research.