High Serum Neuron-Specific Enolase Level Is Associated with Mild Cognitive Impairment in Patients with Diabetic Retinopathy

Zi-Wei Yu,* Rong Liu,* Xin Li, Ying Wang, Yu-Hong Fu, Hui-Yao Li, Yue Yuan, Xin-Yuan Gao Department of Endocrinology, The First Clinical Hospital of Harbin Medical University, Harbin 150001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xin-Yuan Gao Tel +86 13904517001 Email 15369337970@163.comPurpose: Diabetic retinopathy (DR) can increase the risk of mild cognitive impairment (MCI), which has been confirmed by previous researches. With the frequent occurrence of MCI in patients with DR, the early detection of MCI has become a research hot-spot. The aim of this study was to investigate the relationship between neuron-specific enolase (NSE) and MCI in patients with DR.Patients and Methods: A total of 124 patients with DR, including 56 MCI patients and 68 normal cognition patients, were recruited in this cross-sectional study. The demographic and clinical data of patients were collected through questionnaires. Serum NSE was measured using electrochemiluminescence immunoassay. The Minimum Mental State Examination (MMSE) scale was used to evaluate the cognitive function of the participants.Results: Compared with the normal cognition group, serum NSE levels and HbA1c levels in the MCI group were higher, while MMSE scores and educational level were lower (P< 0.05). Serum NSE levels were significantly negatively correlated with MMSE total score, attention and calculation score, and language score (P< 0.05). After adjusting for confounding factors, serum NSE still increased the MCI risk in DR patients (OR:1.606, 95CI%:1.264– 2.041, P< 0.001). The areas under the receiver operating characteristics (ROC) curves (AUC) of the crude model and the adjusted model were 0.75 and 0.73, respectively.Conclusion: A high serum NSE level is an independent risk factor for MCI in DR patients. In addition, serum NSE is expected to be a potential biomarker in DR patients with MCI.Keywords: neuron-specific enolase, mild cognitive impairment, type 2 diabetes mellitus, diabetic retinopathy