The predictive value of lipoprotein associated-phospholipase A2 and homocysteine combined with white matter hyperintensities on cognitive impairment in patients with cerebral small vessel disease
- VernacularTitle:血清Lp-PLA2、Hcy联合WMH对脑小血管病患者认知障碍的预测价值
- Author:
Aiju JIAO
1
;
Ruolan ZHU
;
Chunhua ZHANG
;
Wenrui LI
;
Xia SUN
;
Weijing ZHAO
;
Baolong REN
Author Information
- Publication Type:Journal Article
- Keywords: cerebral small vessel diseases; 1-Alkyl-2-acetylglycerophosphocholine esterase; cognitive impairment; homocysteine; ROC curve; white matter hyperintensities
- From: Tianjin Medical Journal 2025;53(8):846-850
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the predictive value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and homocysteine(Hcy)combined with white matter hyperintensities(WMH)for cognitive impairment in patients with cerebral small vessel disease(CSVD).Methods A total of 240 patients with CSVD were selected.According to the Montreal Cognitive Assessment(MoCA)scale,all subjects were divided into the non-cognitive impairment group(MoCA≥26 points,120 cases)and the cognitive impairment group(MoCA＜26 points,120 cases).Paraventricular white matter high signal(PWMHs)and deep white matter high signal(DWMHs)were scored by Fazekas scale.The sum of the two parts was the total score,and the severity of DWMHs was graded by the score.The basic information,serum Lp-PLA2,Hcy level and severity of WMH were compared between the two groups.Logistic regression was applied to analyze influencing factors of cognitive impairment in CSVD patients.The predictive value of serum level of Lp-PLA2 and Hcy and WMH for cognitive impairment in CSVD patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the non-cognitive impairment group,patients of the cognitive impairment group were older,had higher serum levels of Lp-PLA2 and Hcy,and had more severe of WMH(P＜0.05).Results of Logistic regression analysis showed that serum Lp-PLA2,Hcy levels and severity of WMH were influencing factors for cognitive impairment of patients with CSVD(P＜0.05).The results of ROC curve analysis showed that the area under the curve of serum Lp-PLA2,Hcy level combined with severity of WMH predicting cognitive impairment in patents with CSVD was 0.812,the sensitivity was 81.7%and the specificity was 71.7%(P＜0.05).Conclusion Patients with cognitive impairment caused by CSVD have higher serum levels of Lp-PLA2 and Hcy,and more severe WMH.The combination of the three has a relatively high predictive value for cognitive impairment in patents with CSVD.
