Serum levels and clinical significance of ANGPTL2 and NRG-1 in Parkinson's disease patients

SUN Longyin; MENG Ying; WANG Jiaying

doi:10.11958/20252282

Abstract：Objective To explore the clinical significance of serum angiopoietin-like protein 2(ANGPTL2)and neuregulin-1(NRG-1)levels in patients with Parkinson´s disease(PD).Methods A total of 274 PD patients and 266 healthy volunteers were selected as the observation group and the control group,respectively.The Montreal Cognitive Assessment(MoCA)was used to evaluate the cognitive function of PD patients,and patients were divided into the cognitive impairment group(MoCA score<26,n=161)and the non-cognitive impairment group(MoCA score≥26,n=113).The Hoehn-Yahr(H-Y)scale was used to grade the severity of PD,and patients were classified into the H-Y stages 1-2(118 cases),the stage 3(94 cases)and the stage 4(62 cases).Enzyme-linked immunosorbent assay(ELISA)was used to measure serum ANGPTL2 and NRG-1 levels in both groups.Pearson correlation analysis was used to examine the relationship between serum ANGPTL2 and NRG-1 levels in PD patients.Logistic regression was used to analyze influencing factors of PD.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic efficacy of both markers for PD.Results The serum NRG-1 and education years of PD patients were prominently lower in the observation group than those of the healthy group(P＜0.05),and the serum ANGPTL2 and proportion of PD family history were prominently higher in the observation group than those of the control group(P＜0.05).The serum ANGPTL2 levels were higher in the cognitive impairment group than those of the non cognitive impairment group(P＜0.05),and NRG-1 prominently lower than the non cognitive impairment group(P＜0.05).The serum ANGPTL2 levels increased successively in PD patients with H-Y stages 1-2,3 and 4,and serum NRG-1 lvevels decreased successively(P＜0.05).The serum levels of ANGPTL2 and NRG-1 were negatively correlated in PD patients(r=-0.373,P＜0.001).Logistic regression analysis showed that elevated serum ANGPTL2 levels were the independent risk factors affecting the occurrence of PD,while high level of NRG-1 was an independent protective factor for PD(P＜0.05).The area under the curve(AUC)of serum ANGPTL2,NRG-1 and their combined diagnosis for PD was 0.689(95%CI:0.645-0.733),0.717(95%CI:0.674-0.760)and 0.768(95%CI:0.729-0.808),respectively.The combined diagnosis of the two was superior to the individual prediction of ANGPTL2 and NRG-1(ZANGPTL2-combination=2.608,ZNRG-1-combination=2.017,P=0.009,P=0.044).Conclusion PD patients have elevated serum ANGPTL2 levels and reduced NRG-1 levels,with the extent of these changes correlating with disease severity.Combined testing of these two indicators has important clinical value for the diagnosis of PD.