Clinical Analysis Of Cerebral Small Vessel Disease And Its Associated Cognitive Impairment With Related Indexes Of Iron Metabolism

Objective:This study aimed to explore the possible relationship between cerebral small vessel disease and its associated cognitive impairment and related indexes of iron metabolism such as serum iron,ferritin,total iron binding capacity,hemoglobin,to provide possible directions for the prevention and treatment of cerebral small vessel disease and its associated cognitive impairment.Methods:The clinical data of 60 patients with cerebral small vessel disease(CSVD)who were treated in the neurology department of the first hospital of Jilin University were collected.Among them,there were 30 cases without cognitive impairment and 30 cases with cognitive impairment,and clinical data of another 30 healthy people were collected.And the clinical data Include: gender,age,past history(hypertension,diabetes,smoking history,drinking history and,etc.),auxiliary examination(including fasting blood glucose,glycated hemoglobin,triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,D-dimer,fibrinogen,serum iron,ferritin,total iron binding capacity,hemoglobin,head MRI,neck ultrasonography,transcranial Doppler ultrasound,etc.),and neuropsychological examination for all subjects,including MMSE,MOCA,Hamilton depression scale,Hamilton anxiety scale,ADL and CDR.The healthy people were taken as the normal control group(group A);the patients with cerebral small vessel disease were taken as the test group(group B),and all of the clinical data between the two groups were analyzed;the patients without cognitive impairment in group B as group B1,the patients with cognitive impairment as group B2,and the related indexes of iron metabolism were compared between the two groups,including serum iron,ferritin,total iron binding capacity and hemoglobin;the correlations between serum iron ions,ferritin,total iron binding capacity,hemoglobin and neuropsychological scale scores and the severity of cerebral hemorrhage and white matter lesions in group B were analyzed.Result:1.There were statistically significant differences in age,hypertension,diabetes,glycated hemoglobin,and high density lipoprotein cholesterol between the A and B groups(P <0.05),and age was independently related to the CSVD(OR=1.211,95% CI: 1.067~1.375,P=0.003);gender,hyperlipidemia,smoking history,drinking history,fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein cholesterol,D-dimer,and fibrinogen between the two groups were not statistically significant(P> 0.05).2.There were statistically significant differences in ferritin and total iron binding capacity between the A and B groups(P <0.05),and ferritin was independently related to the CSVD(OR=1.015,95% CI: 1.005~1.025,P=0.003);the levels of serum iron and hemoglobin between the two groups were not statistically significant(P> 0.05).3.There was statistically significant difference in hemoglobin between the B1 and B2 groups(P <0.05);the levels of serum iron,ferritin and total iron binding capacity between the two groups were not statistically significant(P> 0.05).4.The level of total iron binding capacity of patients in group B was positively correlated with the total score of the MOCA scale and negatively correlated with the score of the ADL scale;the level of hemoglobin was positively correlated with the total score of the MMSE scale and the scores of its time and location orientation ability,and positively correlated with the total score of the MOCA scale and the scores of its visual space and execution ability,naming,delayed recall,and orientation ability;there was no correlation between serum iron and ferritin and total scores of MMSE and MOCA.5.There was no significant correlation between serum iron,ferritin,total iron binding capacity,hemoglobin and the severity of cerebral hemorrhage and white matter lesions.Conclusion:1.Age,hypertension,diabetes,glycated hemoglobin and high density lipoprotein cholesterol are related to the occurrence of CSVD.2.The levels of ferritin and total iron binding capacity may be related to the occurrence of CSVD.3.The levels of total iron binding capacity and hemoglobin may be related to the severity of cognitive impairment in patients with CSVD.4.The related indexes of iron metabolism such as serum iron,ferritin,total iron binding capacity and hemoglobin may not relate to the severity of cerebral hemorrhage and white matter lesions.