Abstract:

Objective　To investigate the serum levels of amyloid A (SAA), high-sensitivity C-reactive protein (hs-CRP), and insulin-like growth factor 1 (IGF-1) in patients with Parkinson's disease (PD) and their correlations with disease severity, and to assess the value of these biomarkers in the evaluating disease progression and providing prognostic guidance. Methods　A total of 122 patients with PD treated at Xidian Group Hospital from January 2021 to October 2023 were selected as an observation group, and were divided into an early-stage group (44 cases) and a middle-late stage group (78 cases) according to their disease severities. Among the 122 patients, there were 64 males and 58 females; they were (68.13±8.45) years old; their disease course was (6.06±2.71) years. Fifty healthy examinees during the same period were selected as a healthy control group, including 28 males and 22 females who were (67.25±7.59) years old. The levels of SAA, hs-CRP, and IGF-1 were compared between the 3 groups, and their correlations with the disease severity were analyzed. Multivariate regression analysis was employed to identify the risk factors influencing disease progression. The diagnostic values of SAA, hs-CRP, and IGF-1 in disease progression assessment were evaluated using the receiver operating characteristic curves (ROC). t and χ² tests were applied. Results　The levels of SAA and hs-CRP in the observation group were higher than those in the healthy control group [(9.53±1.50) mg/L vs. (3.71±1.06) mg/L and (5.37±2.74) mg/L vs. (0.82±0.29) mg/L; both P<0.05]; the level of IGF-1 in the observation group were lower than that in the healthy control group [(65.73±15.25) μg/L vs. (84.04±19.72) μg/L; P<0.05]. The disease severity was correlated with the levels of SAA, hs-CRP, and IGF-1 (r=0.587, 0.492, and -0.660; all P<0.05). The multifactorial regression analysis revealed that advanced age, long disease duration, high levels of SAA and hs-CRP, and a low level of IGF-1 were significant predictors of increased disease severity. The combined predictive model of SAA, hs-CRP, and IGF-1 showed an area under the curve (AUC) of 0.967, with a sensitivity of 92.3% and a specificity of 93.2%. Conclusion　The serum levels of SAA, hs-CRP, and IGF-1 are closely associated with the disease progression of patients with PD and can serve as important biomarkers for assessing disease progression.

Key words:

Parkinson's disease, SAA, hs-CRP, IGF-1, Disease progression

摘要：

目的　探讨血清淀粉样蛋白A（serum amyloid A，SAA）、高敏C反应蛋白（high-sensitivity C-reactive protein，hs-CRP）、胰岛素样生长因子-1（insulin-like growth factor 1，IGF-1）在帕金森病（Parkinson's disease，PD）患者中的表达水平及其与病情严重程度的相关性，从而评估这些生物标志物在PD患者病情评估及预后指导中的价值。方法　选取2021年1月至2023年10月西电集团医院收治的122例PD患者为观察组，并根据疾病病情分为早期组（44例）和中晚期组（78例）。122例PD患者中，男64例，女58例，年龄（68.13±8.45）岁，病程（6.06±2.71）年。以同期50名健康体检者为健康对照组，其中男28例，女22例，年龄（67.25±7.59）岁。比较3组SAA、hs-CRP和IGF-1水平，分析其与疾病病情的相关性。使用多元回归分析影响疾病进展的风险因素。采用受试者操作特征曲线（receiver operating characteristic curve，ROC）评价SAA、hs-CRP和IGF-1在疾病进展评估中的应用价值。采用t检验、χ²检验。结果　观察组SAA、hs-CRP水平高于健康对照组［（9.53±1.50）mg/L比（3.71±1.06）mg/L、（5.37±2.74）mg/L比（0.82±0.29）mg/L］，IGF-1水平低于健康对照组［（65.73±15.25）μg/L比（84.04±19.72）μg/L］（均P<0.05）。疾病严重程度与血清SAA、hs-CRP和IGF-1水平相关（r=0.587、0.492、-0.660，均P<0.05）。多因素回归分析显示，高龄、长病程、高SAA、高hs-CRP、低IGF-1是PD患者疾病严重程度加重的影响因素。血清SAA、hs-CRP和IGF-1水平联合预测的曲线下面积（area under the curve，AUC）为0.967，灵敏度为92.3%，特异度为93.2%。结论　血清SAA、hs-CRP和IGF-1水平与PD患者疾病进展密切相关，可作为评估疾病进展的生物标志物。

关键词:

帕金森病, SAA, hs-CRP, IGF-1, 疾病进展