Association Between Levels Of D-Dimer,Fibrinogen And Glycated Hemoglobin And Cognitive Impairment In Patients With Cerebral Small Vessel Disease And Diabetes

Background and objectiveCerebral small vessel disease(CSVD)is a syndrome related to clinical,imaging and pathological manifestations,which is caused by many reasons involving cerebral arterioles,arterioles,capillaries,and venues.Because the disease is hidden and not easy to detect,the clinical diagnosis mainly depends on neuroimaging examination.The clinical significance of CSVD patients is stroke and recurrence,vascular disability,cognitive impairment(VCI),dementia,affective disorder and depressive symptoms,impaired balance,gait disorder and urinary incontinence,increased risk of thrombolysis,anticoagulation and antiplatelet therapy.CSVD cognitive impairment has gradually become a research hotspot because of its hidden onset,slow progress and high incidence.Among them,there are more and more researches on biomarkers related to CSVD cognitive impairment.The main purpose of this study is to detect the plasma levels of D-dimer,fibrinogen and glycosylated hemoglobin in patients with cerebral micro vascular disease complicated with diabetes,to explore the correlation between these three levels and the cognitive function of patients with diabetes mellitus,and to explore the mechanism of cognitive impairment,so as to provide basis for the diagnosis and treatment of cognitive impairment in patients with CSVD complicated with diabetes.MethodsA total of 100 patients with cerebral small vessel disease combined with diabetes who were hospitalized in neurology department of our hospital from November 2021 to November 2022 were selected.All the patients were evaluated by professional doctors and were eligible for admission to the group.After joining the group,we collected the general data of the patients,including age,sex,height,weight,history of hypertension,history of coronary heart disease and so on.The relevant laboratory indexes of urea,creatinine,total cholesterol,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homocysteine,uric acid,glycated hemoglobin,fibrinogen,D-dimer and so on were collected.The cognitive function of the patients was assessed according to the Montreal Cognitive Assessment Scale(Mo CA),and they were divided into 48 patients in the case group(with cognitive impairment,Mo CA<26)and 52 patients in the control group(with normal cognition,Mo CA≥26).To compare and analyze the relationship between D-dimer,fibrinogen,glycosylated hemoglobin levels and cognitive function in patients with cerebral small vessel disease complicated with diabetes.Results1.The comparison of general data between the cognitive impairment group and the cognitive normal group of patients with cerebral small vessel disease combined with diabetes showed that there was no statistical significance in gender,age,body mass index,smoking history,drinking history,hypertension history and coronary heart disease history between the groups(all P>0.05),indicating that the data between the groups were comparable.2.Compared with the cognitive impairment group and the cognitive normal group,the levels of homocysteine and uric acid in the cognitive impairment group were increased,with statistical significance(all P <0.05),while the levels of urea,creatinine,total cholesterol,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,were not statistically significant between the two groups(all P >0.05).3.Compared with normal cognitive function group,the levels of D-dimer,fibrinogen and glycosylated hemoglobin in the cognitive impairment group were increased,with statistical significance(P<0.05).4.After single variable filtering,homocysteine and uric acid,glycosylated hemoglobin,fibrinogen and D-dimer were taken as independent variables and cognitive impairment as dependent variables.The results showed that the OR values were homocysteine(OR=1.557,P=0.000),glycosylated hemoglobin(OR=1.917,P=0.023)fibrinogen(OR=1.768,P=0.042),D-dimer(OR=1.838,P=0.044),which showed that homocysteine,glycosylated hemoglobin,fibrinogen and D-dimer were associated with cognitive impairment in patients with cerebral small vessel disease complicated with diabetes,and the homocysteine was most closely related to cognitive impairment.Elevated levels of homocysteine,glycosylated hemoglobin,fibrinogen and D-dimer could increase the risk of cognitive impairment.Conclusion1.The levels of D-dimer,fibrinogen and glycosylated hemoglobin in cerebral small vessel disease patients with diabetes were related to cognitive impairment.2.The level of D-dimer,fibrinogen and glycosylated hemoglobin increased in patients with cerebral small vessel disease and diabetes,and the degree of cognitive impairment was increased.3.The level of homocysteine in patients with cerebral small vessel disease combined with diabetes is related to cognitive impairment,the level of homocysteine increased,and the degree of cognitive impairment worsen.