Qin Qi, Yin Yunsi, Xing Yi, Wang Xuan, Wang Yan, Wang Fan, Tang Yi
Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China.
Department of Endocrinology, Mudanjiang Second People's Hospital, Mudanjiang, China.
Front Neurol. 2021 Nov 19;12:709134. doi: 10.3389/fneur.2021.709134. eCollection 2021.
Vascular cognitive impairment (VCI) is a major public health problem. The current diagnosis of VCI is made based on the assessment of clinical symptoms and neuropsychological measurements, and is supported by neuroimaging. These methods are both time-consuming and expensive, which leads to needs for alternative biomarkers for VCI. Metabolomics is an emerging and powerful tool to discover of new biomarkers of disease, which can investigate variations in different metabolic processes such as lipid, since the brain is highly enriched in lipids and that lipid changes may lead to pathology in the brain. Vascular cognitive impairment is vulnerable to the disturbance of lipid metabolism. Furthermore, blood samples, which could be identified as reliable clinical biomarkers are relatively convenient to obtain and provide a non-invasive assessment. Therefore, our study aims to understand whether peripheral lipid biomarkers can be used as diagnostic biomarkers and monitor the progression of VCI. We systematically searched the PubMed, Embase, CNKI, and VIP databases to find VCI and lipid metabolism in reports from inception through February 2021. Studies meeting the following criteria were eligible: (1) original studies in humans; (2) lipid metabolites in blood; (3) reports of VCI. Through our review, nine original articles were eligible. Blood-based metabolites that might be potential biomarkers were identified. Most of them including PC, PE, Cers, and ChEs were significantly lower, while elevation of FAs and DGs were associated with VCI. Most importantly, these blood-based metabolites might be proposed as potential biomarkers for VCI, which provides direction for further validation. To the best of our knowledge, this is the first systemic review concerning the relationship of lipid metabolism and VCI. It identifies potential biomarkers and provides insights into the disease pathobiology. However, more advanced studies and researches on a lipidomic platform must be done to understand the exact pathology behind and identify potential lipid biomarkers, which might help achieve the goal of discovering novel therapeutics.
血管性认知障碍（VCI）是一个重大的公共卫生问题。目前VCI的诊断基于临床症状评估和神经心理学测量，并得到神经影像学的支持。这些方法既耗时又昂贵，这就导致需要寻找VCI的替代生物标志物。代谢组学是一种新兴且强大的工具，可用于发现疾病的新生物标志物，它可以研究不同代谢过程中的变化，如脂质代谢，因为大脑富含脂质，且脂质变化可能导致脑部病变。血管性认知障碍易受脂质代谢紊乱的影响。此外，血液样本相对容易获取且能提供无创评估，有望成为可靠的临床生物标志物。因此，我们的研究旨在了解外周脂质生物标志物是否可作为诊断生物标志物并监测VCI的进展。我们系统检索了PubMed、Embase、CNKI和VIP数据库，以查找从创刊至2021年2月期间有关VCI与脂质代谢的报告。符合以下标准的研究 eligible：（1）人体原始研究；（2）血液中的脂质代谢物；（3）VCI报告。通过我们的综述，有9篇原始文章符合要求。确定了可能作为潜在生物标志物的血液代谢物。其中大多数，包括磷脂酰胆碱（PC）、磷脂酰乙醇胺（PE）、神经酰胺（Cers）和胆碱酯酶（ChEs）显著降低，而脂肪酸（FAs）和二酰甘油（DGs）升高与VCI相关。最重要的是，这些血液代谢物可能被提议作为VCI的潜在生物标志物，这为进一步验证提供了方向。据我们所知，这是第一篇关于脂质代谢与VCI关系的系统性综述。它确定了潜在生物标志物，并为疾病病理生物学提供了见解。然而，必须在脂质组学平台上进行更深入的研究，以了解背后的确切病理并确定潜在的脂质生物标志物，这可能有助于实现发现新型治疗方法的目标。
