Zhu Shuzhen, Wei Xiaobo, Yang Xiaohua, Huang Zifeng, Chang Zihan, Xie Fen, Yang Qin, Ding Changhai, Xiang Wei, Yang Hongjun, Xia Ying, Feng Zhong-Ping, Sun Hong-Shuo, Yenari Midori A, Shi Lin, Mok Vincent Ct, Wang Qing
1Department of Neurology and.
2Department of Orthopedics, Zhujiang Hospital of Southern Medical University, Guangdong, China.
Aging Dis. 2019 Aug 1;10(4):834-846. doi: 10.14336/AD.2019.0304. eCollection 2019 Aug.
Lipoprotein-associated phospholipase A2 (Lp-PLA2) and superoxide dismutase (SOD) are linked to regulating vascular/neuro-inflammation and stroke. Using a retrospective design, we investigated whether circulating Lp-PLA2 and SOD in cerebral small vessel disease (CSVD) patients were associated with cognitive impairment. Eighty-seven CSVD patients were recruited. Plasma Lp-PLA2 and SOD were determined, and cognitive status was measured by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The severity of white matter hypoerintensities (WMHs) in CSVD patients was rated according to Fazekas scales, and Lp-PLA2/SOD levels and MMSE/MoCA were compared. Multiple linear regressions were used to evaluate the relationship between Lp-PLA2 and SOD and the cognitive impairment. Ordinal logistic regression and generalized linear models (OLRGLMs) were applied to confirm whether Lp-PLA2 and SOD are independent risk factors for cognitive impairment in CVSD. Lp-PLA2 and SOD with mild or severe cognitive impairment were lower than those with normal congnition. Lp-PLA2 and SOD in CSVD patients with severe WMHs were significantly lower than those with mild or moderate WMH lesions. We noted positive linear associations of Lp-PLA and SOD with cognitive impairment in CSVD, independent of LDL-C. OLRGLMs confirmed that Lp-PLA2 and SOD were independent risk factors of cognitive impairment in CSVD. Lp-PLA2 and SOD are independently associated with cognitive impairment and WMH lesion, and may be useful for the rapid evaluation of cognitive impairment in CSVD. Lp-PLA2/SOD are modifiable factors that may be considered as therapeutic targets for preventing cognitive impairment in CSVD.
脂蛋白相关磷脂酶A2（Lp-PLA2）和超氧化物歧化酶（SOD）与调节血管/神经炎症及中风有关。我们采用回顾性设计，调查了脑小血管病（CSVD）患者循环中的Lp-PLA2和SOD是否与认知障碍相关。招募了87例CSVD患者。测定血浆Lp-PLA2和SOD，并通过简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）测量认知状态。根据 Fazekas 量表对CSVD患者的白质高信号（WMH）严重程度进行分级，并比较Lp-PLA2/SOD水平与MMSE/MoCA。采用多元线性回归评估Lp-PLA2和SOD与认知障碍之间的关系。应用有序逻辑回归和广义线性模型（OLRGLMs）来确认Lp-PLA2和SOD是否为CVSD中认知障碍的独立危险因素。轻度或重度认知障碍患者的Lp-PLA2和SOD低于认知正常者。重度WMH的CSVD患者的Lp-PLA2和SOD显著低于轻度或中度WMH病变患者。我们注意到，在CSVD中，Lp-PLA和SOD与认知障碍呈正线性相关，且独立于低密度脂蛋白胆固醇（LDL-C）。OLRGLMs证实Lp-PLA2和SOD是CSVD中认知障碍的独立危险因素。Lp-PLA2和SOD与认知障碍和WMH病变独立相关，可能有助于快速评估CSVD中的认知障碍。Lp-PLA2/SOD是可改变的因素，可被视为预防CSVD中认知障碍的治疗靶点。
