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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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. 腔隙性腦梗死患者認知障礙與高同型半胱氨酸血癥、梗死灶數目及體積的相關性. 山東大學學報(醫學版), 2016, 54(10): 46-49, 54.
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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.
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15.	張偉宏, 蔡柏薔, 王京蘭, 等. 肺氣腫的CT肺功能成像: CT技術與肺功能檢查的對照研究. 中華結核和呼吸雜志, 2002, 25(3): 150-153.
16.	張敏, 張盼盼, 韓曉慶, 等. 不同程度慢性間歇低氧對大鼠齒狀回Nogo-A和NgR表達的影響. 中華老年心腦血管病雜志, 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, 江濤. 單核/巨噬細胞及其趨化因子與腦缺血再灌注損傷. 國外醫學(腦血管疾病分冊), 2000, 8(2): 89-91.
20.	譚曦舒, 李立群, 胡玲玲, 等. COPD患者血清MCP-1、SAA水平與認知功能的相關性研究. 四川大學學報(醫學版), 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, 謝小紅, 張仁榮, 等. 高同型半胱氨酸血癥與腦梗死合并慢性阻塞性肺疾病患者認知障礙的相關性及藥物干預研究. 中國生化藥物雜志, 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. 腔隙性腦梗死患者認知障礙與高同型半胱氨酸血癥、梗死灶數目及體積的相關性. 山東大學學報(醫學版), 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, 孫永昌, 等. 慢性阻塞性肺疾病肺氣腫表型的臨床與病理生理特征分析.中華結核和呼吸雜志, 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氣腫表型CT GOD評分與肺功能及其預后的相關性研究.中國實用內科雜志, 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. 張偉宏, 蔡柏薔, 王京蘭, 等. 肺氣腫的CT肺功能成像: CT技術與肺功能檢查的對照研究. 中華結核和呼吸雜志, 2002, 25(3): 150-153.
16. 張敏, 張盼盼, 韓曉慶, 等. 不同程度慢性間歇低氧對大鼠齒狀回Nogo-A和NgR表達的影響. 中華老年心腦血管病雜志, 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, 江濤. 單核/巨噬細胞及其趨化因子與腦缺血再灌注損傷. 國外醫學(腦血管疾病分冊), 2000, 8(2): 89-91.
20. 譚曦舒, 李立群, 胡玲玲, 等. COPD患者血清MCP-1、SAA水平與認知功能的相關性研究. 四川大學學報(醫學版), 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, 謝小紅, 張仁榮, 等. 高同型半胱氨酸血癥與腦梗死合并慢性阻塞性肺疾病患者認知障礙的相關性及藥物干預研究. 中國生化藥物雜志, 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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