基于血清标记物的老年认知障碍相关吞咽功能障碍风险评估

Risk assessment of dysphagia related to elderly cognitive impairment based on serum biomarkers

中文关键词: 老年, 认知障碍:吞咽障碍, GDF15, 血清标记物

英文关键词: elderly  cognitive impairment  dysphagia  GDF15  serum biomarker

中文摘要:

      目的 探讨包含GDF15在内的血清生物标志物在老年认知功能障碍患者并发吞咽功能障碍风险评估中的潜力.方法 回顾性分析2023年8月-2024年3月淮安市第一人民医院83例老年认知功能障碍患者资料,根据是否合并吞咽功能障碍分为认知功能障碍组(A组)与认知障碍合并吞咽功能障碍组(B组).对比2组在一般特征、血生化指标、血清标志物水平等方面的差异;采用洼田饮水试验评估吞咽功能;通过ELISA检测血清GDF15水平,并利用ROC曲线分析GDF15、IL6、PAB、ALB共4项生物标志物对吞咽障碍的预测能力.结果 与A组相比,B组年龄较大,牙齿缺损程度更严重,且高脂血症比例更高,提示这些因素可能增加认知障碍患者出现吞咽功能障碍的风险.血清标志物分析显示,B组的GDF15、IL6和CRP水平升高,而PAB和ALB水平则较低,这表明炎症反应和营养不良在吞咽功能障碍的发生中可能起重要作用.ROC曲线分析进一步验证了 GDF15(AUC=0.808)和PAB(AUC=0.828)在吞咽功能障碍预测中的有效性.构建的基于GDF15、IL6、PAB和ALB的逻辑回归模型,其AUC值达0.909,显示出较高的预测效能,提示联合使用多项标志物能更准确地评估吞咽功能障碍的风险.结论 血清GDF15和PAB可能是预测老年认知功能障碍患者吞咽功能障碍的有效生物标志物,且基于上述4项生物标志物的联合预测模型具有较高的预测效能.

英文摘要:

      Objective To explore the potential of serum biomarkers including GDF15 in risk assessment of dysphagia in elderly patients with cognitive impairment.Methods A retrospective analysis was conducted on data from 83 elderly patients with cognitive impairment admitted to Huai'an First People's Hospital between August 2023 and March 2024.They were divid-ed into two groups based on the presence or absence of dysphagia:the cognitive impairment group(group A)and the cognitive impairment complicated with dysphagia group(group B).The differences in general characteristics,blood biochemical indica-tors and serum biomarker level were compared between the two groups.The Kubota Drinking Test was used to evaluate swallo-wing function.Serum GDF15 level were detected by ELISA.ROC curve was used to analyze the predictive ability of the bio-markers(GDF15,IL6,PAB and ALB)for dysphagia.Results Compared with the group A,the group B was significantly older,had more severe tooth defects,and had a significantly higher rate of hyperlipidemia,suggesting that these factors may in-crease the risk of dysphagia in patients with cognitive impairment.Serum biomarker analysis showed that the levels of GDF15,IL6 and CRP in the group B were significantly higher,while the levels of PAB and ALB were lower,indicating that inflamma-tory response and malnutrition might play an important role in the occurrence of dysphagia.ROC curve analysis further con-firmed the predictive effectiveness of GDF15(AUC=0.808)and PAB(AUC=0.828)for dysphagia.The constructed logis-tic regression model based on GDF15,IL6,PAB,and ALB had an AUC value of 0.909,demonstrating high predictive per-formance and suggesting that the combined use of multiple biomarkers could provide a more accurate risk assessment for dys-phagia.Conclusion Serum GDF15 and PAB may be effective biomarkers for predicting dysphagia in elderly patients with cog-nitive impairment.The combined prediction model based on the above four biomarkers has a high predictive accuracy.