Study On The Relationship Between The Ratio Of Trigiyceride To High Density Lipoprotein And The Total Burden And Cognitive Impairment Of Cerebral Small Vessel Diseases

Objective:To study the relationship between the ratio of triglyceride to high density lipoprotein(TG/HDL)and the total burden of patients with cerebral small vessel diseases(CSVD),and to further explore the correlation between the level of TG/HDL and cognitive impairment in patients with CSVD,so as to provide a new reference for the prevention and control of CSVD in the future.Methods:A total of 186 patients with CSVD treated in Hebei Provincial people’s Hospital from January 2019 to December 2022 were selected retrospectively,the general clinical data,laboratory and imaging data of all patients were collected and the data were preserved completely.According to the CSVD total burden score standard,all patients were divided into 118 cases in the mild to moderate burden group(0～2 points)and 68 cases in the severe burden group(3～4 points).Secondly,according to the education level of the patients,according to the score of mini-mental state examination,the patients were divided into normal cognitive group(n=100)and cognitive impairment group(n=86).T-test,Mann-Whitney U,χ~2 test,binary Logistic regression analysis,Spearman correlation analysis were used to analyze the data to explore the relationship between TG/HDL and the total burden of cerebral small vessel diseases and its cognitive impairment.Results:1.The age,HDL,TG/HDL,Hcy and male in the severe burden group were higher than those in the mild to moderate burden group,with statistically significant differences(P<0.05).The indexes of BMI,SBP,DBP,UA,TC,LDL,VLDL,APOEA,APOEB,Smoking,Drinking and Hypertention between the mild to moderate and heavy burden groups were not statistically significant.2.The severity of CSVD total burden was positively correlated with TG/HDL(r=0.383,P<0.001)and Hcy(r=0.335,P<0.001),negatively with HDL(r=-0.264,P<0.001),positively with age(r=0.153,P=0.037),and negatively with males(r=-0.153,P=0.037).However,the indexes of BMI,SBP,DBP,UA,TC,LDL,VLDL,APOEA,APOEB,Smoking,Drinking and Hypertention had no correlation with the severity of CSVD total burden.3.Taking the total burden of CSVD as the dependent variable,the independent variables with statistical significance in Spearman correlation analysis were analyzed by univariate regression(P<0.05),the results showed that age,HDL,TG/HDL,Hcy,male were correlated with severe burden group.Then,after correcting the confounding factors and including the above factors into multivariate regression analysis,the results showed that age(OR=1.045,95%CI:1.009～1.083,P=0.015),TG/HDL(OR=1.393,95%CI:1.011～1.921,P=0.043)and Hcy(OR=1.078,95%CI:1.026～1.133,P=0.003)were independent risk factors for the increase of total burden of CSVD.It is also suggested that for every 1 unit increase of TG/HDL,the severity of CSVD load increases to 1.393 times.4.The SBP,HDL,TG/HDL,VLDL,male,smoking,drinking and hypertention history in the cognitive impairment group were higher than those in the normal cognitive group,with statistically significant differences(P<0.05).Multivariate regression analysis showed that TG/HDL(OR=7.510,95%CI:3.254～17.331,P<0.001)was an independent risk factor for cognitive impairment in patients with CSVD.The results of Spearman correlation analysis showed that TG/HDL in patients with CSVD was negatively correlated with the total score of Mo CA(r=-0.147,P=0.045),visual space and executive ability(r=-0.174,P=0.017),attention(r=-0.170,P=0.020),but not with naming,language,abstraction,delayed recall and orientation.Conclusion:1.The severity of CSVD total burden was positively correlated with TG/HDL and Hcy,and positively correlated with age.2.Age,TG/HDL and Hcy were independent risk factors for the increase of total burden in patients with CSVD,and the severity of CSVD burden increased by 1.393 times when TG/HDL increased by 1 unit.3.TG/HDL is an independent risk factor for cognitive impairment,and the higher the level of TG/HDL-C,the more severe the cognitive impairment.4.The higher the level of TG/HDL,the more serious the degree of cognitive impairment in CSVD,which affects visual space and executive ability,attention is the most significant,and there is a negative correlation.