Relationship between serum biomarkers and cognitive impairment in ischemic cerebral small vessel disease with impaired glucose regulation

doi:10.3969/j.issn.1009-0126.2025.06.025

Abstract：Objective To explore the relationship between serum myeloperoxidase (MPO), phosphorylated tau protein 181, and beta-amyloid protein 1-42 with cognitive impairment in patients with ischemic cerebral small vessel disease (ICSVD) with impaired glucose regulation (IGR). Methods A total of 300 IGR-ICSVD patients admitted to the Department of Neurology at the Affiliated Hospital of North China University of Technology from October 2021 to September 2023 were consecutively selected. According to the Montreal Cognitive Assessment (MoCA) scores, the patients were divided into a normal cognitive function group (n=163) and a cognitive impairment group (n=137), with the latter further divided into mild cognitive impairment (n=80), moderate cognitive impairment (n=45), and severe cognitive impairment (n=12). Baseline data between the two groups were compared; levels of MPO, phosphorylated tau protein 181, and beta-amyloid protein 1-42 were compared between the two groups. Multivariate logistic regression analysis was used to identify independent risk factors for cognitive impairment. Levels of MPO, phosphorylated tau protein 181, and beta-amyloid protein 1-42 were compared among patients with different degrees of cognitive impairment. Pearson correlation analysis was used to assess the correlation between MPO, phosphorylated tau protein 181, and beta-amyloid protein 1-42 levels and the severity of cognitive impairment. Results The levels of MPO, phosphorylated tau protein 181, and beta-amyloid protein 1-42 were significantly higher in the cognitive impairment group than in the normal cognitive function group (P < 0.05, P < 0.01). Multivariate logistic regression analysis showed that total cholesterol, phosphorylated tau protein 181, MPO, and beta-amyloid protein 1-42 were independent risk factors for cognitive impairment in IGR-ICSVD patients (OR = 1.614, 95% CI: 1.065–2.432, P = 0.023; OR = 1.051, 95% CI: 1.012–1.092, P = 0.017; OR = 1.062, 95% CI: 1.022–1.103, P = 0.002; OR = 1.327, 95% CI: 1.239–1.421, P = 0.000). Comparison of MPO, phosphorylated tau protein 181, and beta-amyloid protein 1-42 levels among patients with different degrees of cognitive impairment showed statistically significant differences (P < 0.01), and the levels of these biomarkers gradually increased with the severity of cognitive impairment. Pearson correlation analysis showed that the levels of MPO, phosphorylated tau protein 181, and beta-amyloid protein 1-42 were positively correlated with the severity of cognitive impairment in IGR-ICSVD patients (r = 0.368, P = 0.000; r = 0.345, P = 0.000; r = 0.301, P = 0.000). Conclusion MPO, phosphorylated tau protein 181, and beta-amyloid protein 1-42 are associated with cognitive impairment and its severity in IGR-ICSVD patients. The higher the levels of these biomarkers, the more severe the cognitive impairment.