| Objective To investigate the relationship between serum levels of silent information regulator(Sirtuin) 1-6 and cognitive impairment in Parkinson's disease(PD) patients. Methods A retrospective cohort study was conducted on 121 patients with Parkinson's disease(PD) admitted to Handan Mingren Hospital between April 2021 and May 2023. Based on MoCA scores, the patients were categorized into three groups: dementia group(MoCA score≤17, n=37), mild cognitive impairment group(PD-MCI group)(MoCA score 18-25, n=45), and normal cognitive function group(PD group)(MoCA score≥26, n=39). Additionally, 121 healthy individuals undergoing routine physical examinations were selected as the control group during the same period. Serum expression levels of Sirt1-6 were compared among the study groups. Spearman correlation analysis was used to assess the relationship between serum Sirt1, Sirt2, and Sirt3 levels and cognitive impairment. Ordered multinomial logistic regression was used to identify factors influencing cognitive impairment in patients with Parkinson's disease. Receiver operating characteristic(ROC) curves and area under the curve(AUC) values were analyzed to evaluate the diagnostic efficacy of serum Sirt1, Sirt2, and Sirt3 levels in predicting cognitive impairment in PD patients. Results Serum Sirt2 levels in the study group were higher than those in the control group(P<0.05), while serum Sirt1 and Sirt3 levels were lower than those in the control group(P<0.05). Comparisons of Sirt4, Sirt5, and Sirt6 expression levels among the PD group, PD-MCI group, and dementia group showed no statistically significant differences(P>0.05). Patients in the dementia group exhibited higher serum Sirt2 levels than those in the PD-MCI and PD groups, while their serum Sirt1 and Sirt3 levels were lower than those in the PD-MCI and PD groups(P<0.05). Additionally, statistically significant differences were observed between the PD-MCI and PD groups(P<0.05). Spearman correlation analysis revealed a negative correlation between serum Sirt2 and MoCA scores(P<0.05), while serum Sirt1 and Sirt3 showed positive correlations with MoCA scores(P<0.05). Ordered multivariate logistic regression analysis revealed that Sirt2, disease duration, and the UPDRS Ⅲ score were risk factors for cognitive impairment in patients with Parkinson's disease(P<0.05), while serum Sirt1 and Sirt3 were protective factors(P<0.05). ROC curve results indicated that the combined AUC for predicting PD using serum Sirt1, Sirt2, and Sirt3 levels was higher than the AUC when using Sirt1 alone(0.837), Sirt2 alone(0.748), or Sirt3 alone(0.802). Conclusion Elevated serum Sirt2 levels as well as decreased Sirt1 and Sirt3 levels in PD patients are strongly associated with cognitive dysfunction, and the combined testing of these three markers shows the best predictive efficacy in predicting the occurrence of cognitive dysfunction in PD patients. |
