BDNF和HDL-C与老年帕金森病患者脑白质病变的关系OACSTPCD

Objective To investigate the relationship between serum brain-derived neurotrophic factor(BDNF),high-density lipoprotein cholesterol(HDL-C)and white matter lesions(WML)in elderly Parkinson's disease(PD)patients.Methods Totally 116 elderly patients with PD were strictly selected and recorded as the study group.They were divided into PD-WML group and PD group according to the Fazckas classification.At the same time,40 healthy people matched with demography data were selected as the control group.The relevant data in different groups were compared.The influencing factors of WML in PD patients were analyzed using multivariate Logistic analysis,and the relationship between serum BDNF,HDL-C,and WML in PD patients was analyzed using receiver operating characteristic(ROC)curve.Results The incidence of WML in 116 PD patients was 72.41%(84/116),with 43,30,and 11 cases of gradeⅠ,Ⅱ,and Ⅲ,respectively.The age,incidence of hypertension,and UPDRS-Ⅲscores of the PD-WML group were higher than those of the PD group(P<0.05).Serum BDNF((4.83±1.15)μg/L vs(6.12±1.20)μg/L),TC((4.37±0.96)mmol/L vs(4.84±1.04)mmol/L)and HDL-C((1.07±0.29)mmol/L vs(1.23±0.32)mmol/L)were significantly lower than those in the PD group(P<0.05).Age,hypertension,BDNF,and HDL-C were independent influencing factors for the occurrence of WML in PD patients(P<0.05).The serum BDNF and HDL-C levels in the control group,PD group,WML mild group(grade Ⅰ),and WML moderate to severe group(gradeⅡ-Ⅲ)showed a decreasing trend in sequence(P<0.05).The serum BDNF and HDL-C levels in the WML moderate to severe group were significantly lower than those in the WML mild group(P<0.05).The AUC of serum BDNF,HDL-C,and combined diagnosis of WML in PD patients was 0.834,0.768,and 0.899,respectively.The cut-off values for individual diagnosis were 5.70 μg/L,1.15 mmol/L.The AUC of serum BDNF,HDL-C,and combined diagnosis of moderate to severe WML in PD was 0.820,0.766,and 0.833,respectively.The cut-off values for individual diagnosis were 4.79 μg/L,1.02 mmol/L.Conclusion Serum BDNF and HDL-C are protective factors for the occurrence of WML in PD patients,which can effectively predict the occurrence of WML in PD patients and evaluate the severity of the condition.