Relationships of serum inflammatory biomarker levels with affective and cognitive impairments in patients with cerebral small vessel disease

ZHI Jiaxin; YUAN Zhenyun

doi:10.3969/j.issn.1002-266X.2025.11.003

Abstract：Objective To investigate the correlations between serum inflammatory biomarker levels and affective and cognitive impairments in patients with cerebral small vessel disease(CSVD),providing evidence for clinical early pre-diction and intervention.Methods A retrospective cohort of 227 CSVD patients was selected.Cognitive function was as-sessed using the Montreal Cognitive Assessment and Clinical Dementia Rating Scale,while emotional impairment was eval-uated via the Hamilton Depression Rating Scale.Patients were categorised based on assessment outcomes into:those with neither emotional nor cognitive impairment,those with isolated emotional impairment,those with isolated cognitive impair-ment,and those with emotional and cognitive impairments.The general data and laboratory parameters including low-den-sity lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),uric acid,and C-reactive protein were recorded.Serum inflammatory and immunological markers,neutrophil-to-lymphocyte ratio(NLR),nitric oxide(NO),superoxide dismutase(SOD),interleukin-17A(IL-17A),and interferon-α(IFN-α)were detected.Univari-ate and multivariate Logistic regression analyses were employed to investigate the relationships between serum inflamma-tory and immune markers and the occurrence of affective impairment and cognitive impairment in patients with CSVD.Results Among 227 CSVD patients,55(24.2%)developed affective impairment alone,56(24.7%)developed cogni-tive impairment alone,58(25.6%)developed both affective and cognitive impairments,and 58(25.6%)developed nei-ther affective nor cognitive impairments.Univariate Logistic regression analysis revealed that years of education,LDL-C,HDL-C,IL-17A,IFN-α,SOD,and NO were factors influencing the occurrence of affective disorder,cognitive impair-ment,and combined affective and cognitive impairments in CSVD patients.NLR was a factor influencing affective disorder and combined affective and cognitive impairments(P<0.05).Multivariate Logistic regression analysis revealed that≥12 years of education,elevated HDL-C,and elevated NO were independent protective factors for affective impairment,cogni-tive impairment,and their co-occurrence in CSVD patients.Conversely,elevated LDL-C and elevated IL-17A constituted independent risk factors.Elevated NLR was an independent risk factor for affective impairment and affective-cognitive co-occurrence(all P<0.05).Conclusions Serum inflammatory and immune marker levels are closely associated with affective and cognitive impairments in CSVD patients.Elevated IL-17A and NLR are independent risk factors for affective and cognitive impairments,while elevated NO serves as an independent protective factor.