Analysis Of The Relationship Between Serum Amyloid A,imaging Load,and Cognitive Impairment In Patients With Cerebral Small Vessel Disease

Objective: The purpose of this study is to explore the general clinical features of Cerebral Small Vessel Disease.The study of the relationship between SAA and CSVD imaging and cognitive function provides a new idea for the diagnosis and treatment of Cerebral Small Vessel Disease.Methods: A total of 141 patients with the cerebral small vessel disease were selected from the Department of Neurology of ×××Hospital from August 2021 to August 2022.The general data collected include name,age,sex,history of hypertension,smoking and drinking,systolic blood pressure,and diastolic blood pressure measured after admission.Hematological indicators collected after admission included triglyceride,fasting blood glucose,homocysteine,cholesterol,low-density lipoprotein,high-density lipoprotein,white blood cells,neutrophils,red blood cells,hematocrit,serum amyloid A.All patients were evaluated by MRI,and the characteristics of the imaging markers of each patient were collected.The enlarged perivascular space was quantitatively evaluated as mild EPVS and moderate to severe EPVS.Fazekas score was used to quantify the grade of white matter high signal,which was divided into mild WMH score and moderate to severe WMH score according to the score.Each imaging marker of CSVD was scored,including WMH,LI,CMB and EPVS,with a total score of between 0 and4.Analysis of the relationship between SAA level and imaging load by threshold effect and saturation effect.The cognitive function of patients with CSVD was evaluated,including MMSE and MOCA,and their scores were recorded.The Receiver Operator characteristic Curve was drawn,and the area,optimal threshold,sensitivity,and specificity under the ROC curve were calculated.Results: A total of 141 participants took part in the study,with an average age of 69.67,including 56.7% males and 43.3% females.In multivariate analysis,whether before or after adjusting confounding factors,SAA level was an independent risk factor for WMH severity,the existence of LI and CMB,moderate to severe EPVS,and high total CSVD load,and an independent predictor of cognitive impairment.Through the analysis of the threshold effect and saturation effect,it is found that there is a non-linear relationship between SAA level and WMH score and CSVD total load.Through ROC curve analysis,the area under the curve of SAA for predicting CSVD high load and cognitive impairment was 0.78(sensitivity 73.7%,specificity 77.8%)and 0.72(sensitivity 69.2%,specificity 76.5%).Conclusion: Serum amyloid A level is independently associated with each CSVD MRI marker,total CSVD burden,and cognitive impairment.These findings provide clues for pathological mechanisms and suggest serum amyloid A as a promising biomarker associated with CSVD.