Abstract:

Objective To investigate the level of plasma lipoprotein phospholipase A2（Lp⁃PLA2）and its relationship with cognitive impairment in patients with white matter hyperintensity（WMH）. Methods A total of 97 patients with WMH were selected as case group（WMH group）. According to the MoCA scale，the WMH group was divided into cognitive impairment group（CI group）and non⁃cognitive impairment group（NCI group）. A group of 52 healthy subjects in the same period were selected as healthy control group（HC group）. The plasma Lp⁃PLA2 levels and MoCA scores of patients with WMH were compared with those of HC group. Plasma Lp⁃PLA2 level and MOCA score were analyzed by t⁃test. Logistic regression was used to analyze the risk factors of WMH with cognitive im⁃ pairment，and the relationship between LP⁃PLA2 and cognitive impairment was further analyzed.Results（1）The level of plasma Lp⁃PLA2 in the WMH group was significantly higher than that in the control group，and the MoCA score was significantly lower（P < 0.05）. There were no statistically significant differences between the CI and NCI groups in terms of gender，age，education level，drinking history，uric acid and high ⁃density lipoprotein，total cholesterol，glycerol（P > 0.05），but the differences were statistically significant in terms of history of hypertension， diabetes，smoking，fasting blood glucose，homocysteine，low⁃density lipoprotein cholesterol，and Lp⁃PLA2（P<0.05）. （2）Logistic regression showed that the four indexes of Fasting blood glucose，low⁃density lipoprotein，homocysteine and Lp⁃PLA2 were the risk factors of WMH with cognitive impairment（P<0.05）；（3）The two indicators of homocys⁃ teine，Lp⁃PLA2 had high diagnostic value for WMH with cognitive impairment（AUC=0.703，95%CI：0.508~0.973； AUC=0.751，95% CI：0.611~0.923）. The combined application value was higher（AUC=0.806，95% CI：0.677~ 0.960）. Conclusion WMH patients have higher plasma Lp⁃PLA2 levels. Increased plasma Lp⁃PLA2 levels may be a risk factor for WMH associated with cognitive impairment，and it also has a higher diagnostic and evaluation value.

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