帕金森病患者快速眼动睡眠行为障碍的多因素预测模型构建及血清标志物关联分析OA

Objective To investigate the serum markers for rapid eye movement sleep behavior disorder(RBD)in patients with Parkinson disease(PD)and their predictive value.Methods A total of 132 PD patients who were admitted to Fuxing Hospital,Capital Medical University,from January 2020 to December 2023 were enrolled as subjects,and ac-cording to the presence or absence of RBD,they were divided into RBD group with 47 patients and non-RBD group with 85 patients.The two groups were compared in terms of general information and the serum levels of neurofilaments(NFL),glial fibrillary acidic protein(GFAP),lipoprotein-associated phospholipase A2(Lp-PLA2),neurotrophic factor-3(NT-3),and homocysteine(Hcy).Univariate and multivariate logistic regression analyses were used to investigate inde-pendent risk factors for RBD in PD patients,and the receiver operating characteristic(ROC)curve was used to assess their predictive value.Results Compared with the non-RBD group,the RBD group had significantly higher serum levels of NFL,GFAP,Lp-PLA2,and Hcy(P<0.05)and a significantly lower serum level of NT-3(P<0.05).Serum GFAP(95%CI 0.387‒0.847,P=0.005),Lp-PLA2(95%CI 0.859‒0.947,P=0.005),NT-3(95%CI 1.033‒1.180,P=0.003),and Hcy(95%CI 0.259‒0.655,P<0.001)were significant risk factors for RBD in PD patients.The ROC curve analysis showed that GFAP(AUC=0.767),Lp-PLA2(AUC=0.845),NT-3(AUC=0.829),and Hcy(AUC=0.888)used alone had a good predictive ability,while the combined model of these four indicators had the strongest predictive ability(AUC=0.982),followed by Lp-PLA2+Hcy(AUC=0.944)and GFAP+Hcy(AUC=0.928).Conclusion Serum GFAP,Lp-PLA2,NT-3,and Hcy are significant risk factors for RBD in PD patients and have a good predictive value.The combined model of these four indicators has the strongest predictive ability,suggesting that combined measurement of these indica-tors can be used for early warning of the risk of RBD in PD patients.