Association of Red Blood Cell Indices with Mild Cognitive Impairment in Chinese Elderly Individuals: A Matched Case-control Study
Association of Red Blood Cell Indices with Mild Cognitive Impairment in Chinese Elderly Individuals: A Matched Case-control Study
复制标题
中国老年人红细胞指数与轻度认知障碍的关联：匹配病例对照研究。
DOI：
10.2174/1567205018666210218144856
复制
发表时间：
2020-01-01
影响因子：
2.1
通讯作者：
Huang, Guowei
中科院分区：
文献类型：
--
作者：
Du, Yue;Jin, Mengdi;Huang, Guowei
背景：轻度认知障碍（MCI）是正常衰老和痴呆之间的一个中间且可改变的阶段。迫切需要通过血液生物标志物对MCI进行简单、无创的检测。
目的：本研究旨在回顾性评估红细胞（RBC）指标与MCI的关联，并为中国老年人MCI的检测选择最佳的血液学特征。
方法：采用匹配的病例对照研究，纳入85对MCI患者和健康对照。匹配标准为年龄、性别和教育程度。分析所有样本的红细胞指标，包括血红蛋白（HGB）、红细胞压积（HCT）、平均红细胞体积（MCV）、平均红细胞血红蛋白浓度（MCHC）和红细胞分布宽度标准差（RDW - SD）。采用条件逻辑回归模型评估红细胞指标与MCI之间的关联。通过受试者工作特征（ROC）曲线评估生物标志物的诊断效能。
结果：在所有红细胞指标中，两组之间的血红蛋白（124.82±7.89对133.93±4.52，P<0.001）和红细胞分布宽度标准差（45.29±2.03对41.34±4.41，P<0.001）存在显著差异。在逻辑回归模型中，在调整生活方式因素和合并症后，发现较高的血红蛋白与较低的MCI风险之间存在显著的统计学关联（调整后的比值比：0.831；95%置信区间：0.773 - 0.893），较高的红细胞分布宽度标准差与较高的MCI风险相关（调整后的比值比：1.575；95%置信区间：1.326 - 1.872）。ROC分析表明，血红蛋白和红细胞分布宽度标准差联合使用时ROC曲线下面积（AUC）最大（AUC = 0.842），其次是血红蛋白（AUC = 0.795），最后是红细胞分布宽度标准差（AUC = 0.777）。血红蛋白和红细胞分布宽度标准差联合使用时，敏感度为92%，特异度为89%，总体诊断效率优于单独使用血红蛋白和红细胞分布宽度标准差。
结论：单独的较低血红蛋白和较高红细胞分布宽度标准差被显著发现与MCI风险增加相关，作为诊断标志物具有一定的敏感度和特异度。血红蛋白和红细胞分布宽度标准差联合使用对区分MCI和健康对照更敏感，且具有更高的分类准确性。需要进一步的前瞻性研究来阐明血红蛋白联合红细胞分布宽度标准差是否可能成为阿尔茨海默病早期诊断的潜在诊断工具。
Background: Mild cognitive impairment (MCI) represents an intermediate and modifiable stage between normal aging and dementia. There is an urgent need for simple, non-invasive testing of MCI by blood biomarkers.Objective: This study aimed to retrospectively evaluate the association of red blood cell (RBC) indices with MCI, and select the best hematologic characteristic for detection of MCI in elderly Chinese.Methods: Matched case-control study was carried out with 85 pairs of MCI subjects and healthy controls. The matching criteria was age, gender and education attainment. All samples were analyzed for RBC indices, including hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width-standard deviation (RDW-SD). A conditional logistic regression model was used to evaluate the association between RBC indices and MCI. The diagnostic efficacy of the biomarkers was evaluated by receiver operating characteristics (ROC).Results: Among all RBC indices, there were significant differences in HGB (124.82 +/- 7.89 vs. 133.93 +/- 4.52, P < 0.001) and RDW-SD (45.29 +/- 2.03 vs. 41.34 +/- 4.41, P < 0.001) between two groups. In the logistic regression model, after adjustment for lifestyle factors and comorbidities, significant statistically associations have been found between higher HGB and lower risk of MCI (adjusted OR: 0.831; 95% CI: 0.773-0.893), higher RDW-SD and a higher risk of MCI (adjusted OR: 1.575; 95% CI: 1.326-1.872). ROC analysis suggested that the largest area under the ROC curve (AUC) was found with the combination of HGB and RDW-SD (AUC = 0.842), followed by HGB(AUC = 0.795), and finally by modest RDW-SD (AUC = 0.777). Combination of HGB 43.4 fL yielded a sensitivity of 92% and a specificity of 89%, overall diagnosis efficiency of which were better than HBG and RDW-SD alone.Conclusion: Lower HGB and higher RDW-SD alone were significantly found to be associated with increased risk of MCI, and offered modest sensitivity and specificity as a diagnostic marker. The combination of HGB and RDW-SD was more sensitive and had higher classification accuracy for differentiating MCI from healthy controls. Further prospective research is needed to clarify whether HGB in combination with RDW-SD may be a potential diagnostic tool for early diagnosis of AD.