The Correlation Of The Number Of Peripheral Blood Endothelial Progenitor Cells And Cognitive Function To Age-related White Matter Changes

Objective:1.To detect the change in number of circulating endothelial progenitor cells(EPC) in the patients with age-related white matter changes (ARWMC).To investigate the relationship between the number of circulating EPC and ARWMC.To investigate the correlation of the number of circulating EPC to the severity of ARWMC.To explore the role of EPC in pathophysiology during the development of ARWMC.To provide evidence for preventing and treating ARWMC effectively in future.2.To evaluated the cognitive function of the patients with ARWMC.To investigate the relationship between cognitive function and ARWMC and explore the features of cognitive impairment of the patients with ARWMC.To provide evidence for preventing and treating cognitive impairment in elderly people.Methods:According to the diagnostic criteria of imaging of ARWMC,the research group was made up of 40 patients with ARWMC who were in Neurology Outpatient Department of Tianjin Medical University Hospital during the period from June 2009 to October 2009.The control group was made up of 20 healthy elderly people who were undertaken physical examination in the hospital.There were no white matter changes on CT/MRI of the 20 healthy elderly people.The age and education were matched in the two groups.Forty patients with ARWMC were divided into mild-to-moderate group(n=20,ARWMC score 1 -10) and sever group (n=20, ARWMC score>10) according to the ARWMC scale of CT/MRI scans which had been reported by Wahlund,et al.Mononuclear cells were isolated by density gradient centrifugation,and then the cells were labeled with CD34 polyclonal antibody and CD 133 polyclonal antibody.The flow cytometry was used to identify circulating EPC.The cognitive function was evaluated using Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA,Beijing version). The risk factors including history of hypertension/smoking/drinking/stroke, Body Mass Index(BMI),the years of education,blood-fat and C-reaction protein(CRP) of the objects were all recorded.All the datas were analysed by SPSS 17.0 software.Results:1.Among the risk factors,the incidences of hypertension were only significantly different in the three groups(P＜0.05). The clinical datas were balanced in general,and can be compared.2. The numbers of circulating EPC were significantly different in the three groups(70.50±8.71 in control group,58.99±7.78 in mild-to-moderate group,and 29.50±6.26 in sever group,P＜0.05).The number of circulating EPC was negatively correlated with the severity of ARWMC (r=-0.562,P=0.001).3.The scores of MMSE were significantly different in the three groups(27.10±1.80 in control group,25.80±2.02 in mild-to-moderate group,and 23.85±2.35 in sever group,P＜0.05). The scores of MoCA were significantly different in the three groups(26.60±1.23 in control group,23.30±2.87 in mild-to-moderate group,and 19.80±3.38 in sever group,P＜0.05).The cognitive function of patients with ARWMC was impaired significantly,especially in the visuoconstructional and executive functions, delayed recall and orientation. The scores of cognitive function were not correlated with the severity of ARWMC(MMSE:r=-0.319,P=0.085; MoCA:r=-0.220, P=0.242).The incidences of mild cognitive impairment(MCI) were signitively different in the control group(10.00%) and the research group(47.50%) (χ2=8.242, P=0.004).4.1n the logistic regression analysis,the score of ARWMC was dependent variable,and the risk factors and the number of circulating EPC were independent variable.The results showed that the number of circulating EPC and high-density lipoprotein(HDL) were the predictor of ARWMC,and they were protective factors.Conclusion:1. The number of circulating EPC can be a potential predictor of ARWMC.The change of the number of circulating EPC is an important predictor of the severity of ARWMC. The decrease of the circulating EPC may be one of the important pathogenesis of ARWMC.2. ARWMC may be an important factor of cognitive impairment in elderly people, especially in the visuoconstructional and executive functions, delayed recall and orientation.ARWMC may be the early indicator of cognitive impairment.