Correlation between plasma Aβ and P-tau181 levels and cognitive impairment in maintenance hemodialysis patients

doi:10.11958/20231180

Abstract

Abstract:

Objective To investigate the correlation between plasma β-like amyloid (Aβ), phosphorylated tau181 protein (P-tau181) levels and cognitive impairment (CI) in patients on maintenance hemodialysis (MHD). Methods One hundred and twenty-two MHD patients were divided into the CI group (MoCA score<26, n=47) and the non-CI group (MoCA score≥26, n=75) according to Montreal Cognitive Assessment Scale (MoCA) score. Plasma Aβ and P-tau181 levels were measured using enzyme-linked immunosoradsorption assay. The clinical data were compared between the two groups of patients. Spearman's analysis was used to analyze the correlation between MoCA score and plasma Aβ and P-tau181 levels in MHD patients. Binary Logistic regression was used to analyze influencing factors of concurrent CI in MHD patients. The value of plasma Aβ, P-tau181 levels in diagnosing concurrent CI in MHD patients was analyzed by applying the receiver operating characteristic curve (ROC). Results Compared with the non-CI group, patients in the CI group had lower proportions of hypertension, years of education and diastolic blood pressure, and higher proportions of diabetes, P-tau181 and Aβ levels (P < 0.05). Plasma Aβ and P-tau181 levels were negatively correlated with MOCA scores in MHD patients (r_s=-0.343, -0.402, respectively, P<0.05). Logistic regression analysis showed that elevated P-tau181 and Aβ were risk factors for concurrent CI in MHD patients. ROC curves showed that the areas under the curves for plasma Aβ, P-tau181 and the combination of the two for diagnosis of concurrent CI in MHD patients were 0.725, 0.752 and 0.801, respectively. The difference in diagnostic value between the three was not statistically significant. Conclusion Elevated plasma levels of Aβ and P-tau181 are correlated with the occurrence of CI in MHD patients, and both have good diagnostic value for CI in patients with MHD.

Key words: renal dialysis, continuous renal replacement therapy, cognitive impairment, β-amyloid, phosphorylated tau-181

CLC Number:

R446.11+9

Figures/Tables 4

References 21

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组别	n		男性		年龄/岁		高血压		糖尿病		受教育年限/年			透析龄/月			收缩压/mmHg		舒张压/mmHg
非CI组	75		41（60.3）		51.05±11.85		62（57.4）		14（39.8）		10.00（8.00，12.00）			48（16，108）			144.69±17.36		80.03±12.96
CI组	47		27（39.7）		55.04±14.90		46（42.6）		22（61.1）		7.50（6.00，11.00）			36（16，84）			144.07±19.39		74.86±13.49
t、χ²或Z			0.091		1.553		5.950^＊		10.697^＊		2.716^＊			0.824			0.180		2.061^＊
组别		BMI/（kg/m²）		ALB/（g/L）				TSAT/%				P/（mmol/L）			PTH（ng/L）			P-tau181/（μg/L）
非CI组		22.29±3.22		41.85（39.40，43.80）				0.29（0.24，0.43）				1.74（1.50，1.99）			351.55（183.20，581.20）			52.16（42.50，60.74）
CI组		22.73±2.71		41.20（38.40，43.70）				0.26（0.17，0.38）				1.68（1.43，2.31）			352.10（181.20，513.00）			60.98（53.91，66.68）
t、χ²或Z		0.766		1.015				1.402				0.026			0.037			4.672^＊
组别	Hb/（g/L）					铁蛋白/（μg/L）				TC/（mmol/L）			TG/（mmol/L）			Aβ/（μg/L）				Ca/（mmol/L）
非CI组	115.00（102.00，122.25）					237.95（101.33，468.78）				4.00（3.42，4.37）			1.44（0.96，1.96）			366.03（303.13，409.70）				2.20±0.20
CI组	110.00（101.00，120.00）					346.30（84.40，713.90）				4.00（3.25，4.23）			1.50（1.07，2.66）			421.30（353.93，458.28）				2.23±0.18
t、χ²或Z	1.195					1.786				0.211			1.378			4.167^＊				0.678

组别	n		男性		年龄/岁		高血压		糖尿病		受教育年限/年			透析龄/月			收缩压/mmHg		舒张压/mmHg
非CI组	75		41（60.3）		51.05±11.85		62（57.4）		14（39.8）		10.00（8.00，12.00）			48（16，108）			144.69±17.36		80.03±12.96
CI组	47		27（39.7）		55.04±14.90		46（42.6）		22（61.1）		7.50（6.00，11.00）			36（16，84）			144.07±19.39		74.86±13.49
t、χ²或Z			0.091		1.553		5.950^＊		10.697^＊		2.716^＊			0.824			0.180		2.061^＊
组别		BMI/（kg/m²）		ALB/（g/L）				TSAT/%				P/（mmol/L）			PTH（ng/L）			P-tau181/（μg/L）
非CI组		22.29±3.22		41.85（39.40，43.80）				0.29（0.24，0.43）				1.74（1.50，1.99）			351.55（183.20，581.20）			52.16（42.50，60.74）
CI组		22.73±2.71		41.20（38.40，43.70）				0.26（0.17，0.38）				1.68（1.43，2.31）			352.10（181.20，513.00）			60.98（53.91，66.68）
t、χ²或Z		0.766		1.015				1.402				0.026			0.037			4.672^＊
组别	Hb/（g/L）					铁蛋白/（μg/L）				TC/（mmol/L）			TG/（mmol/L）			Aβ/（μg/L）				Ca/（mmol/L）
非CI组	115.00（102.00，122.25）					237.95（101.33，468.78）				4.00（3.42，4.37）			1.44（0.96，1.96）			366.03（303.13，409.70）				2.20±0.20
CI组	110.00（101.00，120.00）					346.30（84.40，713.90）				4.00（3.25，4.23）			1.50（1.07，2.66）			421.30（353.93，458.28）				2.23±0.18
t、χ²或Z	1.195					1.786				0.211			1.378			4.167^＊				0.678

变量	β	SE	Wald χ²	P	OR（95%CI）
性别	0.294	0.530	0.308	0.579	1.342（0.475~3.792）
年龄	0.010	0.020	0.238	0.626	1.010（0.970~1.051）
受教育年限	-0.085	0.072	1.410	0.235	0.918（0.798~1.057）
透析龄	-0.003	0.005	0.274	0.601	0.997（0.988~1.007）
糖尿病	0.731	0.590	1.534	0.216	2.077（0.653~6.607）
高血压	1.351	1.149	1.382	0.240	3.853（0.406~36.748）
收缩压	-0.006	0.016	0.166	0.683	0.994（0.964~1.024）
舒张压	-0.019	0.021	0.794	0.373	0.981（0.941~1.023）
P-tau181	0.098	0.031	10.308	0.001	1.103（1.039~1.172）
Aβ	0.011	0.004	6.368	0.012	1.011（1.002~1.019）
常数项	-9.126	3.598	6.434	0.011	0.000

变量	β	SE	Wald χ²	P	OR（95%CI）
性别	0.294	0.530	0.308	0.579	1.342（0.475~3.792）
年龄	0.010	0.020	0.238	0.626	1.010（0.970~1.051）
受教育年限	-0.085	0.072	1.410	0.235	0.918（0.798~1.057）
透析龄	-0.003	0.005	0.274	0.601	0.997（0.988~1.007）
糖尿病	0.731	0.590	1.534	0.216	2.077（0.653~6.607）
高血压	1.351	1.149	1.382	0.240	3.853（0.406~36.748）
收缩压	-0.006	0.016	0.166	0.683	0.994（0.964~1.024）
舒张压	-0.019	0.021	0.794	0.373	0.981（0.941~1.023）
P-tau181	0.098	0.031	10.308	0.001	1.103（1.039~1.172）
Aβ	0.011	0.004	6.368	0.012	1.011（1.002~1.019）
常数项	-9.126	3.598	6.434	0.011	0.000

指标	AUC	95%CI	临界值	敏感度	特异度	阳性预测值/%	阴性预测值/%	Youden指数
P-tau181	0.752	0.668~0.836	50.58 μg/L	0.979	0.480	94.95	69.56	0.459
Aβ	0.725	0.635~0.815	415.59 μg/L	0.574	0.800	96.63	15.81	0.374
Aβ+P-tau181	0.801	0.725~0.877		0.979	0.574	69.68	96.47	0.526