血清FABP4、claudin-5、Obestatin水平与精神分裂症患者病情严重程度的关系及对认知功能受损的预测价值OA

Objective To investigate the relationship between serum fatty acid binding protein 4(FABP4),claudin-5 and Obestatin levels and the severity of schizophrenia(SZ),and to analyze their predictive value for cognitive impairment.Methods A total of 118 patients with SZ admitted to the First People's Hospital of Jiangxia District of Wuhan from May 2022 to May 2024 were selected as the disease group,and 120 healthy subjects who underwent physical examination in the First People's Hospital of Jiangxia District of Wuhan dur-ing the same period were selected as the healthy group.According to the positive and negative syndrome Scale score,the patients were divided into mild group,moderate group and severe group.According to the Montreal Cognitive Assessment score,the patients were divided into normal cognitive function group and impaired cog-nitive function group.Enzyme-linked immunosorbent assay was used to detect the serum levels of FABP4,claudin-5,and Obestatin in all subjects.The serum levels of FABP4,claudin-5,and Obestatin in SZ patients with different disease seveity and cognitive functions were compared.Multivariate Logistic regression was used to analyze the influencing factors of cognitive impairment in SZ patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum FABP4,claudin-5,Obestatin alone and their combination for cognitive impairment in SZ patients.Results The serum level of FABP4 in the disease group was lower than that in the healthy group,and the serum levels of claudin-5 and Obestatin were higher than those in the healthy group,and the differences were statistically significant(P<0.05).There were 33 cases in the mild group,40 cases in the moderate group and 45 cases in the severe group.The severe group had a signif-icantly lower serum FABP4 level than the mild and moderate groups,and the moderate group had a signifi-cantly lower serum FABP4 level than the mild group(P<0.05).The serum levels of claudin-5 and Obestatin in the severe group were higher than those in the mild group and the moderate group,and the serum levels of claudin-5 and Obestatin in the moderate group were higher than those in the mild group,and the differences were statistically significant(P<0.05).There were 66 cases in the normal cognitive function group and 52 cases in the impaired cognitive function group.The serum FABP4 level in the impaired cognitive function group was lower than that in the normal cognitive function group,and the serum claudin-5 and Obestatin lev-els were higher than those in the normal cognitive function group,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis showed that increased serum FABP4 level was a protec-tive factor for cognitive impairment in SZ patients(P<0.05),and increased serum claudin-5 and Obestatin levels were risk factors for cognitive impairment in SZ patients(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum FABP4,claudin-5,and Obestatin combined to predict cognitive im-pairment in SZ patients was 0.958,which was higher than the AUC of FABP4,claudin-5,and Obestatin alone(Z=2.592,3.729,2.157,P<0.05).Conclusion The serum FABP4 level is decreased,and the serum claudin-5 and Obestatin levels are increased in SZ patients,which can be used to evaluate the severity of the disease.The combined detection of the three has a higher predictive value for cognitive impairment.