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CN 22-1108/R
Volume 41 Issue 6
Jun.  2025
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Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(6): 1150-1155

Correlation between Kayser-Fleischer ring grading and cognitive function in Wilson’s disease

DOI: 10.12449/JCH250622
  • 1.

    Encephalopathy Center，The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

  • 2.

    Center for Xin’an Medicine and Modernization of Traditional Chinese Medicine，Institute of Health and Medicine，Hefei Comprehensive National Science Center，Hefei 230071，China

  • 3.

    Key Laboratory of Xin’an Medicine，Ministry of Education，Hefei 230038，China

Research funding:

National Natural Science Foundation of China （Joint Fund for Regional Innovation and Development） (U22A20366);

Anhui Provincial Science and Technology Tackling Special Project of Traditional Chinese Medicine (202303a07020004);

Anhui Province Clinical Medical Research Translation Special Program (202204295107020066)

More Information
  • Corresponding author: YANG Wenming， yangwm8810@126.com （ORCID： 0000-0001-8268-9291）
  • Received Date: 2024-10-02
  • Accepted Date: 2025-01-20
  • Published Date: 2025-06-25
    Abstract
  •   Objective  To investigate the correlation with cognitive function based on a new Kayser-Fleischer ring （K-F ring） grading method in Wilson’s disease （WD）.  Methods  A total of 136 WD patients who were hospitalized in Encephalopathy Center， The First Affiliated Hospital of Anhui University of Chinese Medicine， from April 2022 to October 2023 were enrolled. All subjects underwent slit lamp examination， and the grade of K-F ring was determined according to the shape and extent of copper deposition in the cornea， whether it formed a ring or not， and whether there was a sunflower-like cloudy change in the lens. The patients were instructed to complete UWDRS， MoCA， and MMSE scale assessments， and these indicators were compared between patients with different K-F ring grades. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the least significant difference t-test （homogeneity of variance） or the Dunnett’s T3 test （heterogeneity of variance） was used for further multiple comparisons； the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups； the chi-square test was used for comparison of categorical data between groups. The Spearman correlation analysis was used to investigate the correlation of K-F ring grade with UWDRS， MoCA， and MMSE scores.  Results  Among the 136 patients with WD， there were 40 patients with grade 4 K-F ring， accounting for the highest proportion of 29.4%， and 14 patients with grade 0 K-F ring， accounting for the lowest proportion of 10.3%， and there were 22 patients with grade 1 K-F ring （16.2%）， 19 with grade 2 K-F ring （14%）， 25 with grade 3 K-F ring （18.4%）， and 16 with grade 5 K-F ring （11.7%）. According to the different grades of K-F ring， there was a significant increase in UWDRS score （F=22.61， P<0.001） and significant reductions in MoCA and MMSE scores （F=16.40 and 13.80， both P<0.001）. The Spearman correlation analysis showed that K-F ring grade was positively correlated with UWDRS score （r=0.67， P<0.01） and was negatively correlated with MoCA and MMSE scores in WD patients （r=-0.59 and -0.57， both P<0.01）.  Conclusion  The new K-F ring grading method can determine disease severity in WD patients to a certain degree and partially reflect cognitive function and activities of daily living in such patients.

     

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