Relationship between Serum CLU and NRG-1 Levels and the Severity of Cognitive Impairment in Patients with Vascular Dementia and Their Prognostic Value Analysis
Objective:To investigate the relationship between serum levels of clusterin(CLU)and neuromodulin-1(NRG-1)and the severity of cognitive dysfunction in patients with vascular dementia(VD)and their prognostic value.Methods:150 VD patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2020 to November 2022 were selected as the study group.According to the cognitive function score,patients with vascular dementia were divided into mild dementia group of 60 cases,moderate dementia group of 48 cases,and severe dementia group of 42 cases.Follow-up for 6 months,and VD patients were divided into good prognosis group and poor prognosis group based on the follow-up results.During the same period,another 150 healthy volunteers who underwent physical examination at our hospital were selected as the control group.The levels of serum CLU and NRG-1 in the VD group and control group were compared,and the levels of serum CLU and NRG-1 in the different degrees of dementia groups were compared.The factors affecting poor prognosis in VD patients were analysed by univariate and multifactor logistic,the value of serum NRG-1 and CLU in predicting poor-prognosis of VD patients was analyzed by receiver operating characteristic(ROC)curve.Results:Serum CLU levels in VD group were significantly higher than those in controls,while NRG-1 levels were significantly lower than those in controls(P＜0.05).Serum CLU was higher in the moderate and severe dementia groups than in the mild dementia group,while NRG-1 was lower than in the mild dementia group(P＜0.05).The serum CLU was higher in the severe dementia group than in the moderate group,and the NRG-1 was lower than in the moderate group(P＜0.05).There were no lost cases after follow-up for 6 months,with 105 patients in the good prognosis group and 45 patients in the poor prognosis group.Univariate analysis showed that the proportions of age,CLU,smoking,and hyperlipidemia in the poor prognosis group were higher than those in the good prognosis group,while NRG-1,MMSE scores,MoCA scores,and NIHSS scores were lower than those in the good prognosis group(P＜0.05).Multifactor logistic regression analysis showed that elevated serum CLU levels,hyperlipidemia and older age were risk factors for poor prognosis in patients(P＜0.05),while elevated serum NRG-1 levels were protective factors for poor prognosis(P＜0.05).ROC curve analysis found that combined detection of serum NRG-1 and CLU had the highest predictive value for poor prognosis.Conclusion:Serum CLU is elevated in VD patients,while serum NRG-1 is significantly reduced,which is related to cognitive dysfunction.The combination of serum NRG-1 and CLU has a high predictive value for poor prognosis in VD patients,and deserves clinical attention.
Vascular dementiaClusterinNeuromodulin-1Cognitive impairmentPrognosisPredictive value
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