Serum lipoprotein phospholipase A2 level has diagnostic value for cognitive impairment in type II diabetes patients with white matter hyperintensity

Figures & data

Figure 1. Diagram of patient selection, measurement and analysis.

Table 1. Demographic and clinical data of patients with WMH and healthy participants.

Characteristics	WMH (n = 87)	Healthy participants (n = 82)	χ^2/t	P
Age, year	58.1 ± 2.7	57.3 ± 2.4	1.52	0.132
Gender, n (%)			0.029	0.087
Male	52 (59.8)	48 (58.5)
Female	35 (40.2)	34 (41.5)
Education, n (%)			0.145	0.930
Middle school and below	21 (24.1)	18 (22.0)
High school	26 (29.9)	25 (30.5)
College and above	40 (46.0)	39 (47.7)
Hypertension, n (%)	28 (32.1)	22 (26.8)	1.41	0.243
Diabetes mellitus, n (%)	87 (100.0)	12 (14.6)	22.72	<0.01
Smoking, n (%)	25 (28.7)	22 (26.8)	1.76	0.342
Alcohol drinking, n (%)	12 (13.8)	13 (15.6)	0.015	0.943
Fasting blood glucose (mmol /L)	7.6 ± 1.1	6.5 ± 0.8.	8.55	<0.01
Homocysteine (µmol/L)	14.6 ± 1.1	10.7 ± 1.5	9.25	<0.01
Uric acid (µmol/L)	301.5 ± 61.2	298.3 ± 53.4	0.46	0.727
Triglyceride (mmol/L)	1.3 ± 0.3	1.2 ± 0.3	1.59	0.114
Total cholesterol (mmol/L)	4.7 ± 0.8	4.6 ± 0.9	0.45	0.411
High-density lipoprotein cholesterol (mmo/L)	1.8 ± 0.4	1.2 ± 0.3	4.31	<0.01
Low-density lipoprotein cholesterol (mmo/L) (mmo/L)	2.6 ± 0.3	2.5 ± 0.5	1.16	0.125
Fibrinogen (g/L)	2. 9 ± 0.7	2. 8 ± 0. 6	0.61	0.285
Lp-PLA2 (ng/mL)	261.8 ± 23.7	211.2 ± 19.8	6.13	<0.01
MoCA score	25.8 ± 2.7	27.8 ± 2.2	1.91	0.045

Table 2. Demographic and clinical data of WMH patients with CI and NCI.

Characteristics	CI (n = 35)	NCI (n = 52)	χ^2/t	P
Age, year	58.1 ± 2.8	56.3 ± 2.1	1.12	0.112
Gender, n (%)			0.15	0.126
Male	18 (51.4)	34 (65.3)
Female	17 (48.6)	18 (34.6)
Education, n (%)			0.285	0.243
Middle school and below	11 (31.4)	10 (19.2)
High school	12 (34.4)	14 (26.9)
College and above	12 (34.2)	12 (538)
Hypertension, n (%)	13 (37.1)	12 (23.8)	1.11	0.543
Smoking, n (%)	12 (34.3)	13 (25.0)	1.16	0.542
Alcohol drinking, n (%)	5 (14.3)	7 (13.4)	0.115	0.983
Fasting blood glucose (mmol/L)	7.9 ± 1.1	7.8 ± 0.8.	1.15	0.142
Homocysteine (µmol/L)	15.6 ± 1.9	12.7 ± 1.5	2.33	0.023
Uric acid (µmol/L)	311.5 ± 71.2	312.3 ± 43.1	0.56	0.627
Triglyceride (mmol/L)	1.3 ± 0.3	1.2 ± 0.3	1.78	0.144
Total cholesterol (mmol/L)	4.7 ± 0.7	4.6 ± 0.8	0.52	0.521
High-density lipoprotein cholesterol (mmo/L)	1.9 ± 0.4	1.4 ± 0.3	5.31	<0.01
Low-density lipoprotein cholesterol (mmo/L) (mmo/L)	2.6 ± 0.4	2.5 ± 0.5	1.43	0.121
Fibrinogen (g/L)	2. 9 ± 0.9	2. 8 ± 0. 6	0.62	0.295
Lp-PLA2 (ng/mL)	282.8 ± 25.7	221.2 ± 21.8	7.12	<0.01
MoCA score	21.8 ± 2.7	25.8 ± 2.2	1.99	0.042

Table 3. Significant risk factors of cognitive impairment identified by multivariate logistic regression analysis in DMII patients with WMH.

Variables	β	S.E.	Wald χ^2	P	OR	95%CI
High-density lipoprotein cholesterol	0.213	0.223	14.132	<0.001	2.316	1.495–3.588
Homocysteine	1.211	0.157	5.715	0.021	1.497	0.910–2.129
Lp-PLA2	0.654	0.121	14.222	<0.001	3.384	1.329–4.861
Constant	−3.540	0.171	40.717	<0.001	0.029

Adjusted for age, gender, education level, smoking, drinking, hypertension, diabetes, triglyceride, low-density lipoprotein cholesterol and fibrinogen.

Figure 2. Receiver operating characteristic (ROC) curves of the HDL-C and Lp⁃PLA2 within 24 h after admission for congestive impairment. Abbreviation: AUC, area under the curve.

Table 4. Diagnostic value of high-density lipoprotein cholesterol and Lp⁃PLA2 for cognitive impairment in WMH patients.

Indicator	AUC (95%CI)	Cutoff value	Sensitivity	Specificity	Youden index
High-density lipoprotein cholesterol	0.718 (95%CI: 0.529–0.882)	1.6 (mmo/L)	0.766	0.784	0.450
Lp⁃PLA2	0.818(95%CI: 0.629–0.932)	251.5 (ng/mL)	0.793	0.868	0.521
Combined use	0.858 (95%CI: 0.629–0.972)	22.3	0.819	0.873	0.612

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data are not available.