Value of serum HCY and Cys-C levels for cognitive impairment assessment in elderly patients with both cerebral small vessel disease and obstructive sleep apnea-hypopnea syndrome
10.19845/j.cnki.zfysjjbzz.2024.0053
- VernacularTitle:血清HCY、Cys-C水平在老年脑小血管病合并OSAHS认知障碍中的表达及严重程度评估价值
- Author:
Chen ZHANG
1
;
Jianchun HAO
1
;
Yunfeng LI
1
Author Information
1. Tangshan Hongci Hospital， Tangshan 063000，China
- Publication Type:Journal Article
- Keywords:
Homocysteine;
Cystatin;
Cerebral small vessel disease;
Obstructive sleep apnea-hypopnea syndrome;
Cognitive impairment
- MeSH:
Homocysteine;
Cystatins
- From:
Journal of Apoplexy and Nervous Diseases
2024;41(3):270-275
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of serum homocysteine（HCY） and cystatin C （Cys-C） levels for evaluating the presence and severity of cognitive impairment in elderly patients with both cerebral small vessel disease （CSVD） and obstructive sleep apnea-hypopnea syndrome （OSAHS）.Methods A retrospective study was performed on 150 elderly patients with both CSVD and OSAHS who were treated in our hospital from January to December 2020. The data about HCY and Cys-C levels were collected. According to the presence or absence of cognitive impairment， they were divided into observation group （with cognitive impairment， 41 cases） and control group （without cognitive impairment， 109 cases）. The serum HCY and Cys-C levels of the two groups were compared. The correlations between serum HCY and Cys-C levels and cognitive impairment in patients with both CSVD and OSAHS were analyzed. A binary Logistic regression analysis was performed to determine independent factors affecting cognitive impairment to establish a predictive logistic regression model. Receiver operating characteristic （ROC） curves were plotted to examine the predictive value of HCY， Cys-C， and their combination for cognitive impairment in patients with both CSVD and OSAHS. According to the severity of cognitive impairment， the patients in the observation group were further divided into mild cognitive impairment group （32 cases） and severe cognitive impairment group （9 cases） to compare HCY and Cys-C levels and analyze the value of HCY， Cys-C， and their combination in evaluating the staging of cognitive impairment by using ROC curves.Results The levels of HCY and Cys-C in the observation group were significantly higher than those in the control group （both P<0.05）. The total score of Montreal Cognitive Assessment was negatively correlated with serum HCY and Cys-C level （r=-0.756， -0.713， both P<0.001）. The logistic regression analysis showed that HCY and Cys-C levels were independent influencing factors for cognitive impairment （both P<0.05）. The area under the curve （AUC） of HCY plus Cys-C for prediction was 0.843（0.747-0.934）， which was higher than that of any single indicator （P < 0.05）， with the sensitivity and specificity being 89.32% and 79.25%， respectively. The levels of HCY and Cys-C were significantly lower in the patients with mild cognitive impairment than in those with severe cognitive impairment （both P < 0.05）. The AUC of HCY plus Cys-C in cognitive impairment staging was 0.925（0.849-0.976）， which was higher than that of any single index （P < 0.05）. The sensitivity and specificity were 95.67% and 89.67%， respectively.Conclusion Serum HCY and Cys-C levels are negatively correlated with the development and progression of cognitive impairment in elderly patients with both CSVD and OSAHS. The combined prediction with the two indicators can facilitate the evaluation of the risk and stage of cognitive impairment.
- Full text:2025070915363348515血清HCY、Cys-C水平在老年脑小血管病合并OSAHS认知障碍中的表达及严重程度评估价值.pdf
