| Objective:By detecting the plasma soluble LDL receptor-associated protein 1(s LRP-1)level in patients with cerebral small vessel disease(CSVD)and healthy people,the association between it and white matter lesion(WML)in CSVD was explored,which provided a new theoretical basis for the prevention and diagnosis of WML.Methods:Patients diagnosed with WML by head MRI from December 2021 to December 2022 in Subei People’s Hospital were collected as research subjects,and healthy physical examiners were selected as the control group,the general clinical data of patients were collected,the statistical analysis of baseline data was completed,and the plasma s LRP-1level of healthy control group and white matter degeneration group was detected by ELISA,the baseline data and plasma s LRP-1 level of the two groups were compared.Patients with white matter degeneration who met the enrollment criteria were divided into three groups according to the Faze Kas scale scoring criteria into three groups: mild,moderate and severe,and the differences in plasma s LRP-1 levels between the three groups were compared.The MMSE was performed to further analyze the correlation between plasma s LRP-1 and the degree of WML lesion and cognitive impairment,and the above data were analyzed by SPSS25.0 software,the difference was statistically significant with P<0.05.Results:1.A total of 181 patients who met the enrollment criteria were included as the study group,of which 141 patients completed cognitive function assessment,and 46 healthy physical examiners were included as healthy control groups.2.Compared with healthy controls,patients in the WML group were older [70.00(61.00,74.00)VS 58.50(51.50,67.00)],hypertension [127(70.20%)VS 24(52.20%)],diabetes [65(35.90%)VS 8(17.40%)] were higher,Hb A1 c [6.10(5.70,7.12)VS 5.80(5.50,6.10)],ALT [23.00(19.00,27.00)VS 19.00(17.00,25.00)],Scr [70.00(61.00,85.00)VS 65.00(54.00,76.52)],Cys C [0.92(0.72,1.10)VS 0.71(0.52,1.00)] levels were higher than healthy controls,while plasma s LRP-1 [18.20(7.21,58.00)VS 54(30.20,88.20)] levels were lower than healthy controls.The difference was statistically significant(P<0.05).With or without WML as the dependent variable,the above statistically significant risk factors were taken as independent variables(only included because glycated hemoglobin better reflected the patient’s blood glucose level in the past3 months),and binary logistic regression analysis showed that age [OR=1.084,95%CI(1.039-1.132)],glycated hemoglobin [OR=1.593,95%CI(1.079-2.353)],alanine aminotransferase [OR=1.079,95% CI(1.018-1.143)] was an independent risk factor for WML,and s LRP-1 [OR=0.977,95% CI(0.966-0.988)] was a protective factor for WML(P<0.05).3.According to the severity of WML,after dividing patients into three groups,hypertension,s LRP-1 and the severity of white matter degeneration were compared,and there were statistically significant differences in s LRP-1 levels between mild and Moderate groups [9.29(7.50,66.3)VS 7.88(6.59,55.60)],mild group and severe group[9.29(7.50,66.3)VS 7.14(5.36,40.9)](P<0.05).Ordered logistic regression analysis based on the degree of WML lesions showed that history of hypertension was an independent risk factor for increased severity of WML,and s LRP-1 was a protective factor for WML lesions.Spearman correlation analysis showed that WML severity was positively correlated with history of hypertension(r=0.282,P<0.05)and negatively correlated with s LRP-1 level(r=-0.312,P<0.05).4.According to the MMSE score,WML patients were divided into the group without cognitive dysfunction(n=71)and the group with cognitive dysfunction(n=70),and the baseline data and s LRP-1 levels between the two groups were analyzed,and it was found that the homocysteine [8.00(7.00,10.00)VS 10.00(8.00,13.00)] and s LRP-1 levels[18.84(7.61,65.53)VS 7.48(5.85,30.00)] between the two groups were found There was a statistically significant difference(P<0.05).Taking the presence or absence of cognitive impairment as the dependent variable,homocysteine and s LRP-1 were included as independent variables,and binary logistic regression analysis showed that homocysteine[OR=1.235,95% CI(1.1-1.386)] was an independent risk factor for cognitive dysfunction in WMl patients,and s LRP-1 [OR=0.975,95%CI(0.961-0.99)] was a protective factor for cognitive dysfunction in WML patients(P<0.05).5.According to the severity of cognitive dysfunction,it was divided into 2 groups(no severe cognitive dysfunction was found in the patients in this test),and mild cognitive dysfunction(n=14)and moderate cognitive dysfunction groups(n=56)were found,the plasma s LRP-1 level [18.84(7.61,65.53)VS 7.48(5.85,30.00)] was statistically different between the two groups(P<0.05).6.Pearson correlation analysis showed that plasma s LRP-1 levels were positively correlated with delayed memory(r=0.401)scores in MMSE,which were statistically significant(P<0.05).Conclusion:1.Compared with healthy people,plasma s LRP-1 levels in patients with leukodegeneration were significantly reduced,and plasma s LRP-1 levels were significantly correlated with WML severity.2.Compared with patients with WML without cognitive dysfunction,the plasma s LRP-1 level in WML patients with cognitive dysfunction is significantly reduced,and the plasma s LRP-1 level is lower in patients with severe cognitive impairment,and plasma s LRP-1 level may become a biochemical indicator for predicting cognitive decline in patients with white matter degeneration.3.Low plasma s LRP-1 levels are associated with delayed memory loss in WML patients. |
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