Relationship analysis of homocysteine and CCL2 serum levels with cognitive impairment in COPD patients with different degrees of emphysema_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

CUI Ziyang , WANG Hongyang , WANG Haochen , LI Lirui , SONG Longxia , QI Jiahua , WANG Yue ,  GE Yanlei , LI Liqun , ZHANG Jiabin , LI Hongli , ZHU Xiaoying , ZHANG Ci , LI Zhenzhen

Department of Respiratory Medcine, Affiliated Hospital of North China University of Science and Technology University, Tangshan, Hebei 063000, P. R. China;

Corresponding author：

GE Yanlei, Email: geyanlei1983@sina.com

Keywords：

Chronic obstructive pulmonary disease; Emphysema phenotype; Homocysteine; Chemokine C-C motif ligand 2; Cognitive impairment

DOI：

10.7507/1671-6205.201708006

Video：

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Objective To observe the relationship of serum levels of homocysteine (HCY) and chemokine C-C motifligand 2 (CCL2) with cognitive impairment in COPD patients with different degrees of emphysema. Methods Sixty-twoCOPD patients identified according to emphysema phenotype classification and admitted from January 2016 to March 2017 were recruited in the study. There were 37 cases in emphysema 1-2 grade and 25 cases in emphysema 3-4 grade. Simultaneous 30 healthy subjects undergoing physical examination were recruited as control. Montreal cognitive assessment (MoCA) scale investigation and serum HCY and CCL2 test were completed. Relationship analysis was conducted on serum HCY, CCL2 levels with cognitive impairment in the COPD patients with different degrees of emphysema. Results Compared with the 1-2 grade subgroup, the PaO₂ was lower, PaCO₂ was higher, the plasma HCY and CCL2 levels increased in the 3-4 grade subgroup with significant differences (all P<0.05). MoCA total score and subscores were relatively low in the COPD group with emphysema than the control group (except visuospatial ability scores in the 1-2 grade subgroup). MoCA scores were statistically lower in the 3-4 grade subgroup than those in the 1-2 grade subgroup (allP<0.05). Correlation analysis showed that HCY and CLL2 levels were negatively correlated with MoCA scores and subscores (P<0.01), and HCY and CLL2 were positively correlated (bothP<0.01). The area under the receiver operating characteristic curve of HCY and CLL2 for evaluating cognitive impairment was 0.79 and 0.97, respectively. Conclusion In patients with different degrees of emphysema phenotype, serum HCY and CCL2 levels are increased in different degree, and the degree of emphysema is closely related with cognitive dysfunction.

Citation： CUI Ziyang, WANG Hongyang, WANG Haochen, LI Lirui, SONG Longxia, QI Jiahua, WANG Yue, GE Yanlei, LI Liqun, ZHANG Jiabin, LI Hongli, ZHU Xiaoying, ZHANG Ci, LI Zhenzhen. Relationship analysis of homocysteine and CCL2 serum levels with cognitive impairment in COPD patients with different degrees of emphysema. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(1): 15-19. doi: 10.7507/1671-6205.201708006 Copy

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3.	董芳, 杜怡峰. 腔隙性脑梗死患者认知障碍与高同型半胱氨酸血症、梗死灶数目及体积的相关性. 山东大学学报(医学版), 2016, 54(10): 46-49, 54.
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6.	Yamamoto M, Horiba M, Buescher JL, et al. Overexpression of monocyte chemotactic protein-1/CCL2 in beta-amyloid precursor protein transgenic mice show accelerated diffuse beta-amyloid deposition. Am J Pathol, 2005, 166(5): 1475-1485.
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13.	凌芳, 李瑛, 胡成平. 慢性阻塞性肺疾病肺气肿表型CT GOD评分与肺功能及其预后的相关性研究.中国实用内科杂志, 2014, 34(S1): 37-38.
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15.	张伟宏, 蔡柏蔷, 王京兰, 等. 肺气肿的CT肺功能成像: CT技术与肺功能检查的对照研究. 中华结核和呼吸杂志, 2002, 25(3): 150-153.
16.	张敏, 张盼盼, 韩晓庆, 等. 不同程度慢性间歇低氧对大鼠齿状回Nogo-A和NgR表达的影响. 中华老年心脑血管病杂志, 2015, 17(5): 522-525.
17.	Mathur R, Cox IJ, Oatridge A, et al. Cerebral bioenergetics in stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 1999, 160(6): 1994-1999.
18.	Kirkil G, Tug T, Ozel E, et al. The evaluation of cognitive functions with P300 test for chronic obstructive pulmonary disease patients in attack and stable period. Clin Neurol Neurosurg, 2007, 109(7): 553-560.
19.	李力仙, 江涛. 单核/巨噬细胞及其趋化因子与脑缺血再灌注损伤. 国外医学(脑血管疾病分册), 2000, 8(2): 89-91.
20.	谭曦舒, 李立群, 胡玲玲, 等. COPD患者血清MCP-1、SAA水平与认知功能的相关性研究. 四川大学学报(医学版), 2016, 47(6): 957-959.
21.	Li JG, Chu J, Barrero C, et al. Homocysteine exacerbates β-amyloid pathology, tau pathology, and cognitive deficit in a mouse model of Alzheimer disease with plaques and tangles. Ann Neurol, 2014, 75(6): 851-863.
22.	桂心, 谢小红, 张仁荣, 等. 高同型半胱氨酸血症与脑梗死合并慢性阻塞性肺疾病患者认知障碍的相关性及药物干预研究. 中国生化药物杂志, 2015, 35(4): 116-118.

1. Han MK, Agusti A, Calverley PM, et al. Chronic obstructive pulmonary disease phenotypes: the future of COPD. Am J Respir Crit Care Med, 2010, 182(5): 598-604.
2. Dodd JW, Getov SV, Jones PW. Cognitive function in COPD. Eur Respir J, 2010, 35(4): 913-922.
3. 董芳, 杜怡峰. 腔隙性脑梗死患者认知障碍与高同型半胱氨酸血症、梗死灶数目及体积的相关性. 山东大学学报(医学版), 2016, 54(10): 46-49, 54.
4. Cervellati C, Romani A, Seripa D, et al. Oxidative balance, homocysteine, and uric acid levels in older patients with late onset Alzheimer's disease or vascular dementia. J Neurol Sci, 2014, 337(1-2): 156-161.
5. Sokolova A, Hill MD, Rahimi F, et al. Monocyte chemoattractant protein-1 plays a dominant role in the chronic inflammation observed in Alzheimer's disease. Brain Pathol, 2009, 19(3): 392-398.
6. Yamamoto M, Horiba M, Buescher JL, et al. Overexpression of monocyte chemotactic protein-1/CCL2 in beta-amyloid precursor protein transgenic mice show accelerated diffuse beta-amyloid deposition. Am J Pathol, 2005, 166(5): 1475-1485.
7. El KJ, Luster AD. Mechanisms of microglia accumulation in Alzheimer's disease: therapeutic implications. Trends Pharmacol Sci, 2008, 29(12): 626-632.
8. Pistolesi M, Camiciottoli G, Paoletti M, et al. Identification of a predominant COPD phenotype in clinical practice. Respir Med, 2008, 102(3): 367-376.
9. Fujimoto K, Kitaguchi Y, Kubo K, et al. Clinical analysis of chronic obstructive pulmonary disease phenotypes classified using high-resolution computed tomography. Respirology, 2006, 11(6): 731-740.
10. Kitaguchi Y, Fujimoto K, Kubo K, et al. Characteristics of COPD phenotypes classified according to the findings of HRCT. Respir Med, 2006, 100(10): 1742-1752.
11. 李然, 白澎, 孙永昌, 等. 慢性阻塞性肺疾病肺气肿表型的临床与病理生理特征分析.中华结核和呼吸杂志, 2011, 34(11): 857-858.
12. Ley-Zaporozhan J, van Beek EJ. Imaging phenotypes of chronic obstructive pulmonary disease. J Magn Reson Imaging, 2010, 32(6): 1340-1352.
13. 凌芳, 李瑛, 胡成平. 慢性阻塞性肺疾病肺气肿表型CT GOD评分与肺功能及其预后的相关性研究.中国实用内科杂志, 2014, 34(S1): 37-38.
14. Barbosa EM, Song G, Tustison N, et al. Computational analysis of thoracic multidetector row HRCT for segmentation and quantification of small airway air trapping and emphysema in obstructive pulmonary disease. Acad Radiol, 2011, 18(10): 1258-1269.
15. 张伟宏, 蔡柏蔷, 王京兰, 等. 肺气肿的CT肺功能成像: CT技术与肺功能检查的对照研究. 中华结核和呼吸杂志, 2002, 25(3): 150-153.
16. 张敏, 张盼盼, 韩晓庆, 等. 不同程度慢性间歇低氧对大鼠齿状回Nogo-A和NgR表达的影响. 中华老年心脑血管病杂志, 2015, 17(5): 522-525.
17. Mathur R, Cox IJ, Oatridge A, et al. Cerebral bioenergetics in stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 1999, 160(6): 1994-1999.
18. Kirkil G, Tug T, Ozel E, et al. The evaluation of cognitive functions with P300 test for chronic obstructive pulmonary disease patients in attack and stable period. Clin Neurol Neurosurg, 2007, 109(7): 553-560.
19. 李力仙, 江涛. 单核/巨噬细胞及其趋化因子与脑缺血再灌注损伤. 国外医学(脑血管疾病分册), 2000, 8(2): 89-91.
20. 谭曦舒, 李立群, 胡玲玲, 等. COPD患者血清MCP-1、SAA水平与认知功能的相关性研究. 四川大学学报(医学版), 2016, 47(6): 957-959.
21. Li JG, Chu J, Barrero C, et al. Homocysteine exacerbates β-amyloid pathology, tau pathology, and cognitive deficit in a mouse model of Alzheimer disease with plaques and tangles. Ann Neurol, 2014, 75(6): 851-863.
22. 桂心, 谢小红, 张仁荣, 等. 高同型半胱氨酸血症与脑梗死合并慢性阻塞性肺疾病患者认知障碍的相关性及药物干预研究. 中国生化药物杂志, 2015, 35(4): 116-118.

Chinese Journal of Respiratory and Critical Care Medicine

Relationship analysis of homocysteine and CCL2 serum levels with cognitive impairment in COPD patients with different degrees of emphysema

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