Plasma Lipoprotein-Associated Phospholipase A2 Affects Cognitive Impairment in Patients with Cerebral Microbleeds

Lu Liu; Xiaojiu Zhang; Nan Jiang; Yufeng Liu; Qing Wang; Guanghui Jiang; Xuejing Li; Liandong Zhao; Qijin Zhai

doi:10.2147/NDT.S401603

Plasma Lipoprotein-Associated Phospholipase A2 Affects Cognitive Impairment in Patients with Cerebral Microbleeds

Neuropsychiatr Dis Treat. 2023 Mar 22:19:635-646. doi: 10.2147/NDT.S401603. eCollection 2023.

Authors

Lu Liu^#¹, Xiaojiu Zhang^#^{1

2}, Nan Jiang^#³, Yufeng Liu¹, Qing Wang¹, Guanghui Jiang¹, Xuejing Li⁴, Liandong Zhao¹, Qijin Zhai¹

Affiliations

¹ Department of Neurology, Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, People's Republic of China.
² Department of Neurology, Hongze People's Hospital, Huai'an, Jiangsu, People's Republic of China.
³ Department of Neurology, Lianshui PEople's Hospital Affiliated to Kangda College of Nanjing Medical University, Huai'an, Jiangsu, People's Republic of China.
⁴ Rehabilitation Centre, Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: The plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory biomarker of cerebral microbleeds (CMBs) and may be related to the occurrence, development, and prognosis of cognitive impairment. The present study aimed to investigate the impact of plasma Lp-PLA2 level on the cognitive impairment in patients with CMBs.

Methods: In this study, 213 patients with CMBs confirmed by 3.0 T brain magnetic resonance imaging (MRI) were analyzed. Lp-PLA2 levels were determined by magnetic particle chemiluminescence immunoassay technology, and cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA). The cognitive functions of patients with CMBs were divided into three groups according to the MoCA scale, including normal cognition (NC), mild cognitive impairment (MCI), and moderate-severe cognitive impairment (MSCI). Clinical, laboratory and radiological data of the three groups were analysed. The relationship between plasma Lp-PLA2 and MoCA score in patients with CMBs was investigated through rank correlation analysis and multivariate regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of Lp-PLA2.

Results: CMBs were detected in 213 (30.2%) of 705 patients who underwent 3.0 T MRI. Multiple comparisons showed that plasma Lp-PLA2 in patients with CMBs with normal cognitive scores was significantly lower than that in the other two groups with cognitive impairment (p < 0.05). In the single factor correlation analysis, high level of plasma Lp-PLA2 was negatively correlated with the decrease of MoCA score in patients with CMBs (r =-0.389, p < 0.01). Multivariate regression analysis showed that high plasma Lp-PLA2 was an independent risk factor for a low MoCA score in patients with CMBs (odds ratio [OR]=1.014; 95% confidence interval [CI], 1.002-1.026; p=0.025).

Conclusion: A high level of plasma Lp-PLA2 is positively correlated with the generation of cognitive impairment in patients with CMBs and negatively correlated with the degree of impairment. Plasma Lp-PLA2 is an important indicator of cognitive impairment in patients with CMBs and may provide a therapeutic target for preventing CMB-induced cognitive impairment.

Keywords: cerebral microbleeds; cerebral small vessel disease; cognitive impairment; lipoprotein-associated phospholipase A2; risk factors.

Grants and funding

This study was supported by grants from the National Natural Science Foundation of China (No. 82105004) and Huai’an Natural Science Research Plan (No. HAB202113).