ROC analysis of the clinical significances of TT3,TT4,Hcy,and Cys C in predicting cognitive impairment of patients with cerebral small vessel disease

PENG Xiangrui; LI Bo; ZHAO Anrong

doi:10.3969/j.issn.1002-7386.2023.24.009

Abstract：Objective To investigate the value of total triiodothyronine(TT3),total thyroxine(TT4),homocysteine(Hcy)and cystatin C(Cys C)in predicting cognitive impairment in patients with cerebral small vessel disease(CSVD)and their clinical significances.Methods A total of 129 CSVD patients admitted to our hospital from February 2019 to January 2021 were selected.They were divided into impairment group(n=45)and non-impairment group(n=84)according to the occurrence of CSVD-related vascular cognitive impairment(CSVD-VCI)within 6 months.Baseline data,TT3,TT4,Hcy,and Cys C,and the Mini Mental State Examination Scale(MMSE)scores on admission and at 3 months of treatment were compared between groups.Pearson correlation and partial correlation analysis were performed to identify the correlation of TT3,Hcy and Cys C with MMSE scores.The receiver operating characteristic curve(ROC)was plotted and area under ROC(AUC)was calculated to analyze the detection of TT3,Hcy,Cys C and their combined detection in predicting CSVD-VCI.Results The proportion of patients with hypertension,white matter hyperintensity,resting cerebral infarction,and cerebral microhemorrhage in the impairment group was significantly higher than that of non-impairment group(P<0.05).TT3 and MMSE scores on admission and at 3 months of treatment were significantly lower in the impairment group than those of non-impairment group,while Hcy and Cys C were significantly higher(P<0.05).TT3 on admission and at 3 months of treatment was positively correlated with the MMSE score,and Hcy,and Cys C were negatively correlated it(P<0.05).After adjustment for hypertension,white matter hyperintensity,resting cerebral infarction,and cerebral microhemorrhage,TT3,Hcy,and Cys C on admission and at 3 months of treatment were all significantly correlated with the MMSE score(P<0.05).The AUC of single detection of TT3,Hcy and Cys C and their combined detection at 3 months of treatment was larger than that on admission.Conclusion TT3,Hcy,and Cys C are correlated with the occurrence of cognitive impairment in CSVD patients.A combined detection can be used as an effective plan for predicting cognitive impairment in CSVD patients,thus providing a reference for the clinical prevention and treatment of CSVD-VCI.