Impact Of Serum Alkaline Phosphatase On The Cognitive Impairment In Patients With Subcortical Ischemic Vascular Disease

Objectives To explore the levels of serum alkaline phosphatase(ALP)as well as its impact on the cognitive impairment in patients with subcortical ischemic vascular disease(SIVD).Materials and methods One hundred and fifty-eight SIVD patients who were in the First Affiliated Hospital,Anhui Medical University were divided into two subgroups which included 86 patients with mild cognitive impairment(SVMCI)and 72 patients with vascular dementia(SVa D)according to the severity of cognitive impairment.Sixty-seven old people with normal cognitive function were selected as control qruop.Multiple lacunar infarction(LI)or leukoaraiosis(LA)was detected according to their MRI scan appearances and graded LA according to the severity.Serum ALP was measured by an enzymatic method as well as the Mini-mental State Examination(MMSE)and the Cambridge Cognitive Examination-Chinese Version(CAMCOG-C)were used in assessments.Serum ALP was divided into three groups(ALP<71U/L,ALP71-86U/L,ALP>86U/L)and the occurrence rate of LI,LA and cognitive impairment were compared with each other.The levels of ALP were compared in different cognitive impairment and logistic regression was used to explore the relation between ALP and cognitive impairment..Result The average education years of SIVD is lower than control group.The proportion of high blood pressure,smoking and the level of serum urea nitrogen and ALP in SVa D,SVMCI are significantly higher than control group.The scores of MMSE and CAMCOG in SVa D and SVMCI are all lower than control group.The CAMCOG-C which includes orientation,language,memory,attention,execution,computation,thought,consciousness in SIVD are also significantly lower than control group.Serum ALP was divided into three groups(ALP<71U/L,ALP71-86U/L,ALP>86U/L)and the occurrence rate of LI,LA and cognitive impairment were compared with each other.The incidence of LI,LA and SVa D between three groups have statistical significance(?2=8.008,P=0.018;?2=17.998,P=0.000;?2=12.255,P=0.002).The correlation analysis shows the negative correlation between ALP and MMSE,COMCOG-C(r=-0.350,P=0.000;r=-0.286,P=0.000).The negative correlation also exists between ALP and orientation,language,memory,attention,execution,computation,thought,consciousness(r=-0.193,P=0.004;r=-0.238,P=0.000;r=-0.273,P=0.000;r=-0.261,P=0.000;r=-0.222,P=0.001;r=-0.210,P=0.002;r=-0.218,P=0.001;r=-0.161,P=0.015).The logistic regression shows the positive correlation between serum ALP and cognitive impairment after adjusting sex,age and other confunding factors.However,the relation had gone when futher adjusting the grade of LA.Conclusion The level of serum ALP and the proportion of high blood pressure,smoking in SVMCI,SVa D are significantly higher than control group after adjusting sex,age and other confunding factors.The scores of MMSE and CAMCOG in SVa D and SVMCI are all lower than control group.There are positive correlation between serum ALP and cognitive impairment especially whose grade of LA is severe.