| Objective: The early diagnosis of Parkinson’s disease(PD)is still a current worldwide clinical problem.Kynurenine(KYN)may participate in the occurrence of PD by inducing neuroinflammation,oxidative stress,and mitochondrial dysfunction.The study explored the difference in urine KYN expression levels between early PD patients and healthy people matched by age and gender,and further explored the relationship between urine KYN and early PD patients’ clinical indicators for early diagnosis and screening of PD High-risk groups provide effective biomarkers.Methods: Fory one PD patients hospitalized in the Affiliated Weihai Central Hospital of Qingdao University from February 2019 to August 2019 were enrolled into this study.Forty one healthy people matched by age and gender were selected as the control group.At enrollment,we collected clean catch midstream urine from each participant in the morning,and immediately stored in a-80℃ refrigerator within 30 minutes.All clinical parameters were recorded and preserved such as:gender,age,Hoehn-Yahr stage,disease duration,MMSE score,laboratory examinations.Take the KYN enzyme-linked immunoassay(ELISA)kit and urine samples from the refrigerator before the experiment.After equilibrating to room temperature,centrifuge the urine samples at 2-8℃(2500 rpm)for 20 minutes,and use the KYN ELISA kit to detect the KYN of urine samples by ELISA.Then calculate the linear regression equation of the standard curve using the concentration of the standard and the OD value,calculate the actual concentration based on the OD value of the sample,and then analyze whether there is a statistical difference between the expression level of urine KYN in PD and the control group,and the expression level of urine KYN the correlation with various clinical indicators was analyzed,and the best cutoff value of urine KYN for early diagnosis of PD was given according to ROC curve analysis.Results: 1.The urine KYN in the PD group was significantly higher than the control group(891.95pg/ml vs.640.11 pg/ml,p=0.000).When divided into subgroups by sex,the urine KYN expression level of male PD patients was significantly greater than that of male controls(942.88 pg / ml vs.647.97 pg / ml,p = 0.000),and the urine KYN expression level of female PD patients was also greater than that of the same sex Control((820.05 pg / ml vs.630.07 pg / ml,p = 0.011).2.The correlations between urine KYN levels and clinical parameters:Hoehn-Yahr stage(r=0.676,p=0.000),disease duration(r=0.772,p=0.000),MMSE score(r=-0.434,p=0.005).3.There was no statistically significant correlation between urine KYN with age,low density cholesterol(LDL),homocysteine(HCY),triglycerides(TG),uric acid(UA),cholesterol(TC)and glomerular filtration rate(GFR).4.The urine KYN cut-off value of 751.88pg/m L had a 65.9% sensitivity and a 90.2%specificity for distinguishing between patients with PD and controls,an area under curve(AUC)of 0.776.The urine KYN cut-off value of 823.78pg/m L had a 58.3%sensitivity and a 95.7% specificity for distinguishing between patients with male PD and male controls,and area under curve(AUC)of 0.803.The urine KYN cut-off value of754.45pg/m L had a 64.7% sensitivity and a 100% specificity for distinguishing between patients with female PD and female controls,and area under curve(AUC)of 0.732.Conclusion: 1.High levels of urine KYN are significantly associated with Parkinson’s disease.2.Urine KYN expression level is related to the severity of PD and cognitive dysfunction.3.Urine KYN may be an effective urine biomarker for early diagnosis of PD. |
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