The Relationship Between Homocysteine With White Matter Lesions And Cognitive Function

Objective: To investigate the relationship between homocysteine(Hcy)with white matter lesions(WMLs)and cognitive function.Methods: 106 patients who were hospitalized in the department of neurology of the People’s Hospital of Liaoning Province from December 2017 to October 2019 and met the WMLs diagnostic criteria were observed.16 patients without WMLs were selected as the control group at the same time,The Fazekas scale was used to score WMLs.According to the score,the patients were divided into control group(0 points),mild WMLs group(1 ～ 2 points),moderate WMLs group(3 ～ 4 points),and severe WMLs group(5 ～ 6 points).The level of Hcy was measured.The overall cognitive function,memory,language,executive function and visuospatial function of the patients were evaluated,and the clinical data were collected.Results: 1.A total of 106 patients with WMLs and 16 patients in the control group were included in this study.There were significant differences in sex,hypertension and Hcy levels between WMLs group and control group(P < 0.05).The proportion of hypertension and the level of Hcy in the WMLs group was higher than those in the control group(P < 0.05),and the proportion of males in the control group was higher than that in the WMLs group(P < 0.05).There was no significant difference in age,years of education and so on.2.There were significant differences in age,sex,drinking history and Hcy level among the three groups of WMLs(P < 0.05),and there were no significant differences in years of education,smoking history and so on.3.Age,sex,drinking history,hypertension and Hcy level were taken as independent variables and WMLs as dependent variables,and Logistic regression was conducted.The results showed that Hcy and hypertension were independent risk factors for WMLs,with an OR value of 2.022 and 4.014 respectively.That is to say,for every 1mmol/L increase in Hcy,the risk of WMLs increased by 1.022 times,and the risk of WMLs in patients with hypertension was 4.014 times higher than that in patients without hypertension.4.The MoCA score of WMLs group decreased compared with that of control group(P=0.000).The RAVLT scores of WMLs group(including immediate memory,short-term delayed memory,and long-term delayed memory)all decreased compared with that of control group(P < 0.05),there was no difference in recognition ability score between the WMLs group and the control group(P=0.695).The BNT score of WMLs group decreased compared with that of control group(P=0.014).The time consuming of SCWT in WMLs group increased compared with that in control group(P=0.003).The CDT score of WMLs group decreased compared with that of control group(P=0.042).5.Correlation analysis showed that the degree of WMLs was negatively correlated with the scores of MoCA,immediate memory,short-term delayed memory,long-term delayed memory,BNT and CDT,and positively correlated with the time consuming of SCWT,but not significantly correlated with recognition ability scores.6.Correlation analysis showed that the level of Hcy was negatively correlated with the scores of MoCA,immediate memory,short-term delayed memory,long-term delayed memory,BNT and CDT,and positively correlated with the time consuming of SCWT,but not significantly correlated with recognition ability scores.Conclusions: 1.Hcy is a risk factor for WMLs.2.The overall cognitive,memory,language,executive function and visuospatial function of WMLs patients all decreased,and the more severe the WMLs,the worse the cognitive function.3.The level of Hcy is related to cognition,which can affect the overall cognition,memory,language,executive function and visuospatial function.