Predictive value of three serum biomarkers for cognitive impairment in elderly patients with cerebral small vessel disease

FENG Sanjiang; LI Zeyun; WANG Peng; LIAN Ye; JIN Xiao

doi:10.3969/j.issn.1009-0126.2026.02.020

Abstract：Objective To explore the clinical predictive efficiency of serum chemokine C-X3-C motif ligand 1(CX3CL1),Apelin and homocysteine(Hcy)for cognitive dysfunction in elderly patients with cerebral small vessel disease(CSVD).Methods A total of 78 elderly CSVD patients admitted in the First Nanyang People's Hospital from February 2021 to March 2024 were recruited,and according to the score of Montreal Cognitive Assessment(MoCA),they were divided into a cognitive impairment group(MoCA score<26,31 cases)and a non-cognitive impairment group(MoCA score≥26,47 cases).The serum levels of CX3CL1,Apelin,and Hcy were measured in all participants.Pearson correlation analysis,and ROC curve analysis were used to assess the predictive capacities of these serum markers for cognitive impairment.Results The cognitive impairment group exhibited significantly higher serum levels of CX3CL1,Apelin,and Hcy than the non-cognitive impairment group(P<0.01).Correlation analysis showed that the serum levels of the three indicators were negatively correlated with MoCA score(r=-0.538,-0.443,-0.646,P<0.01).CX3CL1>248.65 μg/L,Apelin>87.57 μg/L and Hcy>24.39 μmol/L were independent risk factors for cognitive impairment in CSVD patients(P<0.05,P<0.01).ROC curve analysis revealed that the AUC values of CX3CL1,apelin,and Hcy in predicting cognitive impairment were 0.837,0.798,and 0.880,respectively,all demonstrating high sensitivity and specificity.Conclusion Serum CX3CL1,Apelin,and Hcy levels are closely associated with cognitive impairment in elderly CSVD patients,and show good predictive value,providing support for early diagnosis and treatment of CSVD.