Correlation between serum β-amyloid 42 level and cognitive impairment in patients with cerebral small vessel disease / 国际脑血管病杂志

ABSTRACT

Objective:To investigate the correlation between serum β-amyloid (Aβ) 42 level and cognitive impairment in patients with cerebral small vascular disease (CSVD).Methods:Consecutive patients with CSVD admitted to the Affiliated Hospital of Jining Medical University from September 2016 to September 2019 were enrolled retrospectively. Montreal Cognitive Assessment (Chinese edition), Clinical Dementia Rating and Center for Epidemiologic Studies-Depression scale were used for neuropsychological evaluations. According to the diagnostic criteria of mild cognitive impairment, they were divided into cognitive impairment group and normal cognitive function group. Multivariate logistic regression analysis was used to identify the independent risk factors for cognitive impairment in patients with CSVD. Receiver operator characteristic (ROC) curve was used to evaluate the predictive value of serum Aβ42 level for cognitive impairment. Results:A total of 171 patients with CSVD were enrolled. The serum Aβ42 was 2.14±0.56 μg/L. Eight-one patients (47.4%) had cognitive impairment, and 90 (52.6%) had normal cognitive function. Univariate analysis showed that there were significant differences in age, smoking, hypertension, diabetes, history of previous stroke or transient ischemic attack, blood pressure, fasting blood glucose and serum Aβ42 between the cognitive impairment group and the normal cognitive function group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for age, smoking, diabetes, blood pressure and history of previous stroke or transient ischemic attack, serum Aβ42 (odd ratio [ OR] 2.974, 95% confidence interval [ CI] 1.632-6.348; P=0.009), hypertension ( OR 2.063, 95% CI 1.340-5.438; P=0.021) and fasting blood glucose ( OR, 1.598, 95% CI 1.167-4.156; P=0.030) were the independent risk factors for cognitive impairment in patients with CSVD. ROC curve analysis showed that the area under the curve of serum Aβ42 was 0.700 (95% CI 0.619-0.782; P<0.001). The optimal cut-off value was 2.39 μg/L, and the sensitivity and specificity were 56.8% and 80.0%, respectively. Conclusions:Aβ42 is independently correlated with cognitive impairment in patients with CSVD, and can be used to predict cognitive impairment in patients with CSVD.