Plasma Lipoprotein-Associated Phospholipase A2 Affects Cognitive Impairment in Patients with Cerebral Microbleeds

Abstract

Purpose The plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory biomarker of cerebral microbleeds (CMBs) and may be related to the occurrence, development, and prognosis of cognitive impairment. The present study aimed to investigate the impact of plasma Lp-PLA2 level on the cognitive impairment in patients with CMBs. Methods In this study, 213 patients with CMBs confirmed by 3.0 T brain magnetic resonance imaging (MRI) were analyzed. Lp-PLA2 levels were determined by magnetic particle chemiluminescence immunoassay technology, and cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA). The cognitive functions of patients with CMBs were divided into three groups according to the MoCA scale, including normal cognition (NC), mild cognitive impairment (MCI), and moderate-severe cognitive impairment (MSCI). Clinical, laboratory and radiological data of the three groups were analysed. The relationship between plasma Lp-PLA2 and MoCA score in patients with CMBs was investigated through rank correlation analysis and multivariate regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of Lp-PLA2. Results CMBs were detected in 213 (30.2%) of 705 patients who underwent 3.0 T MRI. Multiple comparisons showed that plasma Lp-PLA2 in patients with CMBs with normal cognitive scores was significantly lower than that in the other two groups with cognitive impairment ( p < 0.05). In the single factor correlation analysis, high level of plasma Lp-PLA2 was negatively correlated with the decrease of MoCA score in patients with CMBs ( r =−0.389, p < 0.01). Multivariate regression analysis showed that high plasma Lp-PLA2 was an independent risk factor for a low MoCA score in patients with CMBs (odds ratio [OR]=1.014; 95% confidence interval [CI], 1.002–1.026; p =0.025). Conclusion A high level of plasma Lp-PLA2 is positively correlated with the generation of cognitive impairment in patients with CMBs and negatively correlated with the degree of impairment. Plasma Lp-PLA2 is an important indicator of cognitive impairment in patients with CMBs and may provide a therapeutic target for preventing CMB-induced cognitive impairment.

Correlations of Plasma Biomarkers and Imaging Characteristics of Cerebral Small Vessel Disease

“…Another study has suggested that high plasma lipoprotein-associated phospholipase A2 (Lp PLA2) may be a potential and specific biomarker to predict cognitive impairment in CMB patients (ROC = 0.693, p < 0.0001), and the number of CMBs significantly mediates the relationship between Lp PLA2 and cognitive decline ((indirect effect = −0.017, p = 0.031) [ 55 ]. In the central nervous system, Lp-PLA2 induces the loss of pericytes, facilitated by the promotion of oxidative stress and immune responses, which disrupts the blood–brain barrier and allows harmful substances and blood cells to leak into the brain.…”

Higher serum Lp-PLA2 is associated with cognitive impairment in Parkinson’s disease patients

“…Recent research has suggested that Lp-PLA2 may also be involved in the pathogenesis of cognitive impairment. In one study, Lp-PLA2 levels were found to be higher in individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) compared to controls ( Davidson et al, 2012 ; Pokharel et al, 2019 ; Liu et al, 2023 ). Another study found that Lp-PLA2 levels were elevated in individuals with type 2 diabetes and that Lp-PLA2 levels were higher in diabetic individuals with cognitive impairment compared to those without cognitive impairment ( Cai et al, 2017 ).…”