Study On The Correlation Between Serum Homocysteine Level And The Overall Load Of Cerebrovascular Disease

Objective: Cerebrovascular disease is the most serious clinical problem among the elderly,among which the incidence rate of cerebrovascular small vessel disease(CSVD)is getting higher and higher.However,the mechanism of CSVD is still unclear.The previous diagnostic method of CSVD is to rely on image reading.This project plans to use the total load score of CSVD image to evaluate its imaging performance,And explore the relationship between homocysteine(Hcy)levels and the total imaging burden of CSVD.Provide new ideas for the clinical work of CSVD.Method: This study included 80 patients admitted to the affiliated hospital of Chifeng University from January 2021 to April 2022,who underwent cranial magnetic resonance imaging to diagnose CSVD,and collected clinical data.In the morning of the next day when the patient was admitted to the hospital,the nurse collected 4ml of fasting elbow median venous blood beside the bed and sent it to the sterile coagulation promoting blood collection vessel.The patient was sent to the laboratory to use the automatic biochemical analyzer to measure the serum Hcy level and general biochemical indicators(glycosylated hemoglobin,fasting blood glucose,total cholesterol,triglyceride low-density lipoprotein,high-density lipoprotein).Imaging markers include white matter hyperintensities(WMH),cerebral microbleeds(CMBs),lacunar invasions(LI),and perivascular spaces(PVS).According to the total load score of CSVD imaging,patients can be divided into a low load group with a score of 1-2 and a high load group with a score of 3-4.Single factor analysis is used to explore the risk factors of total load of CSVD imaging,and binary logistic regression is used to analyze the independent risk factors of total load of CSVD imaging.Non parametric tests were conducted to investigate the differences in homocysteine levels among different imaging biomarker groups in the total burden of CSVD imaging.Result: A total of 80 patients were included in this study,divided into a high load group and a low load group.In univariate analysis,among the factors such as age,history of hypertension,fasting blood glucose,glycated hemoglobin,and homocysteine(Hcy),the high load group was significantly higher than the low load group,and the difference was statistically significant(P<0.05);In cognitive scores,the high load group was significantly lower than the low load group,with a statistically significant difference(P<0.05);There was no significant difference in smoking history,total cholesterol(T-CHO),triglyceride(TG),low-density lipoprotein(LDL-C),high-density lipoprotein(HDL),small and low-density lipoprotein cholesterol(sd LDL-C)between the high and low load groups(P>0.05);In terms of imaging markers,the comparison between the high and low load groups showed that WMH(88.4% vs.27.0%,P<0.001),CMBs(81.4% vs.59.5%,P=0.031),and PVS(55.8% vs.16.2%,P<0.001)were significantly higher in the high load group than in the low load group,with a statistically significant difference(P<0.05);The difference in LI(100.0% vs.97.3%,P=0.212)was not statistically significant(P>0.05).The results of binary logistic regression analysis showed that Hcy [OR=2.279,95% CI(1.268,4.096)]and cognitive scale score [OR=0.558,95% CI(0.373,0.834)] were independent influencing factors(P<0.05)for the total imaging burden of CSVD patients.There were statistically significant differences in serum Hcy levels between the white matter high signal group,the cerebral microvascular hemorrhage group,and the perivascular space group(P<0.05);There was no statistically significant difference between the lacunar groups(P>0.05).Conclusion: This study found that age,history of hypertension,fasting blood glucose,glycated hemoglobin,cognitive scale scores,and homocysteine(Hcy)are risk factors related to the total load of CSVD,with the proportion of cognitive scale scores and homocysteine(Hcy)being independent risk factors for the total load of CSVD.There are differences in Hcy levels among different imaging biomarkers in CSVD,and Hcy metabolism may be involved in the pathological processes of high white matter signal,cerebral microbleeds,and perivascular space formation in CSVD patients.