血清铁死亡标记物与绝经后女性认知障碍的关系

目的 研究血清铁死亡标记物与绝经后女性认知障碍的关系。方法 选取2019年8月至2021年12月就诊的148例女性,其中生育期女性22例,围绝经期女性11例,绝经后女性115例。按照蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)将绝经后女性分为认知障碍组(n=77)和无认知障碍组(n=38),比较两组血清铁死亡标记物有无差异,应用Logistic进行多因素回归分析绝经后女性认知障碍的相关因素。通过受试者工作特征曲线(Receiver operating characteristic curve, ROC)评估相关因素对绝经后女性认知障碍的诊断价值。结果 与生育期和围绝经期女性相比,绝经后女性MoCA评分明显较低,血清ACSL4、System Xc-、GPX4、GSH、ROS、LPO及MDA水平均明显升高(均P<0.05)。与无认知障碍组相比,认知障碍组绝经后女性受教育年限短、患高血压的比例高,且血清ACSL4、System Xc_-^{、GPX4、GSH、ROS、LPO及MDA水平明显}升高 (均P<0.05)。多因素Logistic回归分析显示教育年限和血清谷胱甘肽(glutathione, GSH)与认知障碍独立相关(P<0.05),ROC曲线分析显示两者联合对预测女性是否患认知障碍具有中度诊断价值(AUC: 0.764, P<0.05)。结论 绝经后女性血清铁死亡标志物ACSL4、System Xc_-^{、GPX4、GSH、ROS、LPO及MDA水平}明显升高,其中GSH与女性认知障碍发生独立相关,与受教育年限联合有望成为绝经后女性认知障碍早期诊断的潜在标志物。

Relationship between serum ferroptosis markers and cognitive impairment in postmenopausal women

Objective To investigate the relationship between serum ferroptosis markers and cognitive impairment in postmenopausal women. Methods A total of 148 women were selected from August 2019 to December 2021, including 22 women in reproductive period, 11 perimenopausal women and 115 postmenopausal women. The postmenopausal women were divided into cognitive impairment group (n=77) and non-cognitive impairment group (n=38) according to the score of Montreal cognitive assessment (MoCA). The levels of serum ferroptosis markers were compared between the two groups, and multivariate logistic regression was used to analyze the factors related to cognitive impairment in postmenopausal women. Receiver operating characteristics (ROC) curve was drawn to study the diagnostic value of related factors for cognitive impairment in postmenopausal women. Results Compared with reproductive and perimenopausal women, the MoCA score of postmenopausal women was significantly lower, and the serum levels of ACSL4, System Xc_^-, GPX4, GSH, ROS, LPO and MDA were significantly higher (all P<0.05). Compared with the group without cognitive impairment, the postmenopausal women with cognitive impairment had shorter years of education, higher proportion of hypertension, and higher serum levels of ACSL4, System Xc_-^{, GPX4, GSH, ROS, LPO and MDA} (all P<0.05). Multivariate logistic regression analysis showed that years of education and serum glutathione (GSH) were correlated with cognitive impairment (both P<0.05). ROC curve analysis showed that the combination of them had moderate diagnostic value in predicting cognitive impairment in postmenopausal women (AUC: 0.764, P<0.05). Conclusion The serum levels of ACSL4, System Xc_-^{, GPX4, GSH, ROS, LPO and MDA were} significantly higher in postmenopausal women, and GSH was independently associated with cognitive impairment. Combined with years of education and GSH may be a potential marker for early diagnosis of cognitive impairment in postmenopausal women.