Association of ApoE ε4 allele, homocysteine, and inflammatory factors (hs-CRP, IL-6, TNF-α) with cognitive dysfunction in Alzheimer's disease patients and development and validation of a predictive model.

OBJECTIVE

This study focuses on the cognitive dysfunction in patients with Alzheimer's disease (AD), aims to in-depth analysis of the Apolipoprotein E (ApoE) gene polymorphism, homocysteine (Hcy) and the intrinsic relationship between the disease, and build accurate and effective prediction model.

METHODS

A total of 193 AD patients were divided into a training set (n = 135) and a validation set (n = 58) according to the ratio of 7:3. The risk factors were screened by univariate and multivariate Logistic regression in the training set, and the nomogram model was constructed. The receiver operating characteristic curve (ROC) was drawn and the calibration curve was used to evaluate the effectiveness of the model. The model was verified in the validation set, and the clinical value was evaluated by decision curve analysis (DCA).

RESULTS

The multivariate Logistic regression analysis showed that high PSQI score, elevated Hcy, ApoE ε4 allele carrying, decreased folic acid, elevated hs-CRP and IL-6 were the independent risk factors for cognitive dysfunction in AD patients (p < 0.05). The nomogram model performed well in the training and validation sets for calibration and prediction, with C-index values of 0.863 and 0.769, respectively, area under ROC curve (AUC) values of 0.870 and 0.771.

CONCLUSION

The nomogram prediction model constructed based on ApoE gene polymorphism and Hcy et al. can be used to predict the risk of cognitive dysfunction in AD patients and provide a reference basis for formulating personalized intervention plan in clinic. However, it still needs further verification by large sample and multi-center study.