The correlation between inflammatory biomarkers and vascular cognitive impairment in patients with cerebral small vessel disease

Abstract

Objective: To investigate the correlation between plasma inflammatory biomarkers MMP-9, Lp-PLA2, IL-6, TNF-α and vascular cognitive impairment in patients with cerebral small vessel disease (CSVD), and to provide theoretical evidence for the early diagnosis and treatment of cognitive impairment in patients with cerebral small vessel disease.

Methods: A total of 400 patients admitted to the Department of Neurology, Xuzhou Central Hospital, for treatment of CSVD from January 2019 to June 2023 were randomly selected. The cognitive function of the patients was assessed using the Montreal Cognitive Assessment (MoCA) scale. Based on the scores, the patients with CSVD were divided into a normal cognition group (n=196) and a cognitive impairment group (n=204). According to the severity of cognitive impairment, the cognitive impairment group was further divided into mild cognitive impairment group (n=100), moderate cognitive impairment group (n=59),and severe cognitive impairment group (n=45). A healthy control group of 100 individuals who underwent physical examinations during the same period was included. The correlation between plasma inflammatory biomarkers MMP-9, Lp-PLA2, IL- 6, TNF-α and vascular cognitive impairment was studied.

Results: Compared with the healthy control group, the levels of smoking, homocysteine (HCY), carotid artery plaque formation, MMP-9, Lp-PLA2, IL-6, TNF-α in the normal cognition group and cognitive impairment group of patients with CSVD were significantly increased, with statistical significance (P<0.05). Moreover, the levels of smoking, HCY, carotid artery plaque formation, MMP-9, Lp-PLA2, IL-6, TNF-α in the cognitive impairment group were higher than those in the normal cognition group, with statistical significance (P<0.05). Multivariate logistic regression analysis showed that after controlling for confounding factors such as smoking, HCY, and carotid artery plaque formation, MMP-9, Lp-PLA2, IL-6, and TNF-α in patients with CSVD were still positively correlated with vascular cognitive impairment (P<0.05) and were independent risk factors. Compared with the mild cognitive impairment group, the levels of plasma MMP-9, Lp-PLA2, IL-6, and TNF-α in patients with moderate and severe cognitive impairment were significantly increased, with statistical significance (P<0.05); compared with the moderate cognitive impairment group, the levels of plasma MMP-9, Lp-PLA2, IL-6, and TNF-α in patients with severe cognitive impairment were significantly increased, with statistical significance (P<0.05). There was a negative linear relationship between plasma inflammatory biomarkers MMP-9, Lp-PLA2, IL-6, and TNF-α levels and cognitive function scores (P<0.05).

Conclusion: Plasma MMP-9, Lp-PLA2, IL-6, and TNF-α are independent risk factors for vascular cognitive impairment in patients with CSVD. Plasma MMP-9, Lp-PLA2, IL-6, and TNF-α levels in patients with CSVD are positively correlated with the severity of vascular cognitive impairment.