Effects Of Atorvastatin On Vascular Mild Cognitive Impairment And Levels Of Plasma 24S-hydroxycholesterol

Objective:To explore the effect of atorvastatin on the cognitive function and plasma24S-hydroxycholesterol level of patients with vascular mild cognitive impairment,so as to provide a clinical basis for the early diagnosis and treatment of vascular mild cognitive impairment.Methods:The clinical data of patients with vascular mild cognitive impairment hospitalized in the Department of Neurology,the Second Affiliated Hospital of Nanchang University from October 2018 to May 2019 were collected.According to the "Guidelines for the Prevention and Treatment of Dyslipidemia in Adults in China(2016 Revision)",the risk stratification,lipids management goals and treatment recommendations are divided according to the 10-year risk of atherosclerotic cardiovascular disease(ASCVD),Lipid-lowering group and enhanced lipidlowering group.The control group was given relevant physical and mental activity exercises,low-fat diet,treatment of primary disease,etc.,and no atorvastatin treatment was given;the lipid-lowering group received oral atorvastatin 20 mg per night on the basis of the control group;On the basis of the control group,atorvastatin was orally administered 40 mg every night.The three groups of patients were treated continuously for 6 months.The changes of MMSE,MoCA score,blood lipid level and plasma 24S-hydroxycholesterol level in the three groups before and after treatment were compared.Results:(1)A total of 152 patients were enrolled at baseline.132 patients completed 6months of follow-up,including 61 males and 71 females.Compared with the control group and the lipid-lowering group,the intensive lipid-lowering group had a higher proportion of patients with hypertension,type 2 diabetes,dyslipidemia,and cerebral infarction.There were no significant differences in age,smoking,drinking,and education level(P> 0.05).(2)There was no significant difference in baseline plasma 24S-hydroxych-olesterol levels among the three groups(P> 0.05).The plasma 24S-hydroxych-olesterol level in the lipid-lowering group and the intensive lipid-lowering group was significantly lower than that of the control group after 6 months of treatment.Compared with the latter difference,the difference was not significant(P> 0.05).(3)Follow-up after 6 months,the MMSE and MoCA scores of patients in the lipid-lowering group and the intensive lipid-lowering group were significantly higher than those of the control group(P <0.05),while there was no difference between the lipid-lowering group and the enhanced lipid-lowering group Statistical significance(P> 0.05).(4)Pearson correlation analysis showed that there was a strong negative correlation between24S-hydroxycholesterol and MMSE scores in each group(r =-0.637,P <0.05);there was a negative relationship between 24S-hydroxycholesterol and MoCA scores in each group Strong correlation(r =-0.742,P <0.05).Conclusion:(1)Atorvastatin can reduce the plasma 24S-hydroxycholesterol level in patients with vascular mild cognitive impairment during 6 months of treatment.There is no difference in the treatment effect between 20 mg and 40 mg.(2)Atorvastatin can improve the cognitive function of patients with vascular mild cognitive impairment during the 6-month course of treatment.There is no difference in the treatment effect between 20 mg and 40 mg.(3)Plasma 24S-hydroxycholesterol level is associated with cognitive impairment and is expected to become a potential biomarker for vascular mild cognitive impairment.