慢性阻塞性肺病与认知障碍的多中心研究：揭示定量 CT、肺功能、HIF-1α 和临床变量之间的相互作用

IF 2.8 3区医学 Q1 Medicine

International Journal of Chronic Obstructive Pulmonary Disease Pub Date : 2024-07-29 DOI:10.2147/copd.s466173

Yopi Simargi, Yuda Turana, Aziza Ghanie Icksan, Alida Roswita Harahap, Kristiana Siste, Muchtaruddin Mansyur, Triya Damayanti, Maryastuti Maryastuti, Vininta Fazharyasti, Indah Puspita Dewi, Yetty Ramli, Marcel Prasetyo, Cleopas Martin Rumende

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引用次数: 0

摘要

目的：认知障碍（CI）与慢性阻塞性肺疾病（COPD）之间的确切联系仍然有限。因此，我们旨在发现定量 CT（QCT）、肺功能、HIF-1α 和临床因素与 COPD 患者发生 CI 的关系和相互作用：一项横断面多中心研究于 2022 年 1 月至 2023 年 12 月进行。我们收集了 114 名慢性阻塞性肺病患者的临床数据、肺活量测定、CT 图像和静脉血液样本。认知障碍评估采用蒙特利尔认知评估印尼语版（MoCA-Ina），截断值为 26。QCT 分析包括肺密度、气道壁厚度、肺动脉与主动脉比率（PA:A），以及使用 3D Slicer 软件的胸肌。使用 ELISA 对血清 HIF-1α 进行分析：结果：我们发现，在 GOLD 分级 I-IV 的患者中，LAA- 950%、年龄、慢性阻塞性肺病病程、体重指数、FEV1 pp 和 FEV1/FVC 之间存在明显差异。只有教育持续时间与 CI 相关（r = 0.40; p < 0.001）。我们发现 GOLD 分级之间的 HIF-1α 没有明显差异（p = 0.149），HIF-1α 与 CI 之间也没有相关性（p = 0.105）。多元线性回归结果显示，MoCA-Ina 评分主要受 %LAA- 950（p = 0.02）和受教育时间（p = 0.01）的影响。路径分析模型显示，%LAA 和受教育时间直接或间接通过 FEV1 pp 对 CI 有影响：我们的结论是，利用 QCT 参数是有益的，因为它可以识别异常并有助于 CI 的发展，这表明它在临床决策中具有潜在的实用性。慢性阻塞性肺病患者的 MoCA-Ina 评分主要受 %LAA- 950 和受教育时间的影响。关键词：慢性阻塞性肺疾病认知障碍肺气肿低氧诱导因子

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A Multicenter Study of COPD and Cognitive Impairment: Unraveling the Interplay of Quantitative CT, Lung Function, HIF-1α, and Clinical Variables

Purpose: The exact link between cognitive impairment (CI) and chronic obstructive pulmonary disease (COPD) is still limited. Thus, we aim to find the relationship and interaction of quantitative CT (QCT), lung function, HIF-1α, and clinical factors with the development of CI among COPD patients.
Patients and Methods: A cross-sectional multicentre study was conducted from January 2022 to December 2023. We collected clinical data, spirometry, CT images, and venous blood samples from 114 COPD participants. Cognitive impairment assessment using the Montreal Cognitive Assessment Indonesian version (MoCA-Ina) with a cutoff value 26. The QCT analysis consists of lung density, airway wall thickness, pulmonary artery-to-aorta ratio (PA:A), and pectoralis muscles using 3D Slicer software. Serum HIF-1α analysis was performed using ELISA.
Results: We found significant differences between %LAA_{− 950}, age, COPD duration, BMI, FEV₁ pp, and FEV₁/FVC among GOLD grades I–IV. Only education duration was found to correlate with CI (r = 0.40; p < 0.001). We found no significant difference in HIF-1α among GOLD grades (p = 0.149) and no correlation between HIF-1α and CI (p = 0.105). From multiple linear regression, we observed that the MoCA-Ina score was influenced mainly by %LAA_{− 950} (p = 0.02) and education duration (p = 0.01). The path analysis model showed both %LAA and education duration directly and indirectly through FEV₁ pp contributing to CI.
Conclusion: We conclude that the utilization of QCT parameters is beneficial as it can identify abnormalities and contribute to the development of CI, indicating its potential utility in clinical decision-making. The MoCA-Ina score in COPD is mainly affected by %LAA_{− 950} and education duration. Contrary to expectations, this study concludes that HIF-1α does not affect CI among COPD patients.

Keywords: chronic obstructive pulmonary disease, cognitive impairment, emphysema lung, hypoxia inducible factor

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来源期刊

International Journal of Chronic Obstructive Pulmonary Disease RESPIRATORY SYSTEM-

CiteScore

5.10

自引率

10.70%

发文量

372

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals