Correlation Between Serum Lipoprotein-associated Phospholipase A2 And Superoxide Dismutase Levels And White Matter Hyperintensities

BackgroundWhite matter hyperintensities is an imaging term proposed by Hachinski,which manifests as diffuse or punctate hyperintensities in T2 or T2-weighted imaging.With the development of imaging science and technology.The detection rate of White matter hyperintensities has gradually increased.The prevalence rate of White matter hyperintensities is as high as 95% for the elderly over 65 years old.The early clinical symptoms of WMH are mostly unobvious,but cognitive dysfunction even dementia may occur in the progress of the disease.At present,the pathogenesis of WMH is not clear,but relevant evidence shows that systemic inflammatory mediators such as lipoprotein-associated phospholipase A2 and superoxide dismutase are involved in the development of White matter hyperintensities and related to it’s cognitive impairment.ObjectiveTo explore the correlation between serum lipoprotein-associated phospholipase A2 and superoxide dismutase levels and white matter hyperintensities.MethodsSeventy-eight patients with White matter hyperintensities confirmed by MRI were selected to visit the First Affiliated Hospital of Xinxiang Medical College from December2018 to November 2020 as study subjects.At the same time,30 healthy subjects were selected.The serum Lp-PLA2 and SOD levels of the two groups were measured and Montreal Cognitive Scale were assessed.The differences of serum Lp-PLA2,SOD levels and Mo CA scores of the two groups were compared by independent sample t test.A total of 78 patients with White matter hyperintensities who met the inclusion criteria were divided into light,medium and heavy groups according to Faze Kas of White matter hyperintensities as indicated by MRI examination results.The differences of serum Lp-PLA2,SOD levels and Mo CA scores among the three groups were compared by ANOVA.Pearson correlation analysis was used to evaluate the correlation between serum Lp-PLA2,SOD levels and the degree of White matter hyperintensities lesion and it’s related cognitive impairment.The diagnostic efficacy of serum Lp-PLA2,SOD levels for White matter hyperintensities and it’s related cognitive impairment was evaluated by receiver operating characteristic curve.Results1.The levels of serum Lp-PLA2 in WMH group were higher than those in control group,while the levels of SOD and Mo CA score were lower than those in control group and the differences were statistically significant(both P<0.05).2.Significant differences was found in the serum Lp-PLA2 and SOD levels among the three groups(both P<0.05).Serum SOD level was negatively correlated with Faze Kas score(r=-0.753,P<0.05).Serum Lp-PLA2 level was positively correlated with Faze Kas score(r=0.757,P<0.05).3.The area under the ROC curve for evaluating the reliability of WMH by serum SOD level was 0.829 and the best diagnostic cut-off value was 153.5U/m L.While the sensitivity was 70.5% and the specificity was 93.3%.The area under ROC curve for evaluating the authenticity of WMH by serum Lp-PLA2 level in diagnosis WMH was0.838 and the best diagnostic cut-off value was 172.5μg/L.While the sensitivity was 60.9%and the specificity was 90.0%.4.The serum SOD level of WMH patients was positively correlated with Mo CA score(r=0.823,P<0.05).Serum Lp-PLA2 level was negatively correlated with Mo CA score(r=-0.657,P<0.05).The area under ROC curve of serum SOD level in diagnosis WMH cognitive impairment was 0.843 and the best cut-off value was 152.5U/m L.The area under ROC curve of serum Lp-PLA2 level in evaluate WMH cognitive impairment was0.854 and the best diagnostic cut-off value was 171.5U/m L.ConclusionThe changes of serum SOD and Lp-PLA2 levels are related to the severity of WMH and cognitive impairment,which is helpful to the assessment of the severity of WMH and cognitive impairment.