Study On The Correlation Between SD-LDL,HS-CRP,LP-PLA2 And SOD Levels And Cerebral Small Vascular Congnitive Impairment

BackgroundNowadays,cerebral small vessel disease（CSVD）is increasing,the number of proportion rises year by year.With the development of modern medical imaging technology,the detection rate of CSVD is also increasing.In recent years,people gradually deepen the understanding of CSVD.It is not only a major risk factor for a variety of clinical acute and chronic neurological diseases,but also causes vascular cognitive impairment（VCI）,and even develop into vascular dementia（Va D）in the long term.At present,new progress has been made in the research of risk factors for cerebral small vascular cognitive impairment（CSVCI）,especially the biological markers,which provide biological reference for the early identification and prevention of CSVCI,and help timely diagnosis and treatment of patients with early cognitive decline,thus delaying the progression of dementia.ObjectivesTo analyze the risk factors affecting cerebral small vascular cognitive impairment;To explore the relationship between the selected related factors and the severity of the occurring cognitive dysfunction;Alone or with testing related risk factors of CSVCI disease clinical diagnosis value,for the doctor can CSVCI early diagnosis in clinical work.MethodsThe study subjects were recruited from September 2020 to February 2022,and the patients treated in the neurology ward and outpatient department of Shangqiu First People’s Hospital were selected.These patients were clearly diagnosed as follo ws by cranial MRI:Recent Small Subcortical Infarct（RSSI）,White Matter Hyperin-Te nsities（WMHs）,Cerebral Microbleeds（CMBs）,Lacunar Infarcts（LIs）,Enlarged Perivascu lar Space（EPVs）,Cerebellar atrophy（CA）.A total of 134 cases were selected as the s ubject group in this study.Its basic information and general clinical data were colle cted in detail.All subjects were scored on the Montreal Cognitive Scale（Mo CA）^[1-2]（Mo CA scale:≥26 in the cognitively normal group;<26 divided into cognitive imp airment group）.The cognitive impairment group was assigned to cerebral small vasc ular cognitive impairment（CSVCI）group,and the cognitive normal group was assi gned to CSVCN group.The whole blood of the subjects from fasting at least 12 ho urs in the morning was taken for centrifugation and precipitation,and the serum w as taken.Different test methods were used to measure the selected indicators of the two groups of research objects.The indexes are small and dense low-density lipop rotein（SD-LDL）,hypersensitive C reaction protein（HS-CRP）,lipoprotein associated phospholipase A2（LP-PLA2）,superoxide dismutase（SOD）.Univariate analysis of general clinical data,past medical history,laboratory selected indicators between the two groups,preliminary screening of relevant indicators;Pearson correlation test was used to analyze the relationship between correlation indexes and Mo CA scale score.The above indicators were incorporated into the multi-factor Logistic regression model to obtain the independent influencing factors of CSVCI.ROC curve was used to evaluate the clinical diagnostic value of single and combined tests for predicting CVSCI diseases.Results1.CSVCI group and CSVCN group:HS-CRP,LP-PLA2,SOD and HCY were significantly different between the two groups.（all P<0.05）;There was no significant difference in SD-LDL between the two groups（P>0.05）;2.The following indicators were statistically significant and different between t he two groups:HS-CRP[（1.77±0.47）mmol/L vs（1.48±0.35）mmol/L];HCY[（14.28±5.72）mmol/L vs（10.41±6.21）mmol/L];SOD[（140.05±30.10）KU/L vs（166.51±23.65）KU/L];LP-PLA2[（56.15±15.07）μg/L vs（39.01±12.53）μg/L];3.The Pearson correlation test showed that HCY,HS-CRP,LP-PLA2 were negatively associated with Mo CA score（r=-0.569,P<0.001;r=-0.416,P<0.001;r=-0.361,P<0.001）;SOD was positively correlated with Mo CA score（r=0.467,P<0.001）.4.The above index of statistically significant:HS-CRP（P<0.001）,HCY（P<0.001）,SOD（P<0.001）,LP-PLA2（P<0.001）were assigned into the Logistic regression mod el and compared.the results showed:HCY（OR=1.093,95%CI=1.016-1.17）;HS-CRP（OR=4.716,95%CI=1.314-16.933）;LP-PLA2（OR=1.098,95%CI=1.053-1.144）may be independent risk factors for CSVCI（all P<0.05）;SOD（OR=0.963,95%CI=0.945-0.981）may be an independent protective factor for CSVCI（P<0.05）.5.The clinical diagnostic value of each index alone and in combination for the occurrence of CSVCI disease:The area under the curve of HCY was 0.740（0.657-0.823）;The area under the curve of HS-CRP was 0.708（0.619-0.798）in CSVCI group;The area under the curve of LP-PLA2 was 0.829（0.758-0.899）;The area under the curve of SOD was 0.770（0.687-0.853）;The area under curve of combined detection for CSVCI group was 0.916（0.867-0.965）,Sensitivity of 92.30%,Speciality of 79.70%,the Youden index is0.720.（All of the above indicators were P<0.05）.Conclusions1.LP-PLA2,SOD,HS-CRP,HCY are associated with cerebral small vascular cognitive impairment;SD-LDL may not be associated with cerebral small vascular cognitive impairment;2.The levels of LP-PLA2,HS-CRP and HCY increased with the aggravation of the degree of cerebral small vascular cognitive impairment.The level of SOD decreased with the aggravation of cerebral small vascular cognitive impairment.3.LP-PLA2,HS-CRP and HCY may be independent risk factors of cerebral small vascular cognitive impairment;SOD may be an independent protective factor of cerebral small vascular cognitive impairment.4.Combined detection of LP-PLA2,SOD,HS-CRP and HCY levels has higher clinical diagnostic value for CSVCI disease than detection of LP-PLA2,SOD,HS-CRP and HCY levels alone.