Abstract:Objective: To investigate the relationship between vascular endothelial growth factor (VEGF) and pigment epithelial derived factors (PEDF) and cognitive disorder caused by cerebral small-vascular disease (CSVD), so as to provide valuable biomarkers for the early warning screening of vascular cognitive impairment (VCI) caused by CVSD. Methods: Patients with CVSD hospitalized in the Neurology Department of The First Affiliated Hospital of Baotou Medical College from June 2019 to June 2020 were continuously enrolled in the study. The relevant clinical data of the patients were collected and 3.0 T cranial MRI examinations were performed on them, including T1-weighted imaging, T2-weighted imaging, fluid attenuated inversion recovery (FLAIR) sequence, diffusion-weighted imaging and susceptibility weighted imaging. Serum VEGF and PEDF level were detected by VEGF and PEDF Elisa Kit. Multivariate logistic regression analysis was used to determine the independent influencing factors of CVSD-caused VCI. SPSS 26.0 was used to describe the receiver operating characteristic (ROC) curve, and the predictive serum VEGF and VEGF level for CVSD-caused VCI was evaluated. Results: A total of 193 patients were enrolled, including 90 patients in VCI group (46.6%) and 103 ones in non-VCI group (53.4%). Compared with non-VCI group, there were significant differences in educational years, past history of hypertension, lacunar infarction or transient ischemic attack (TIA), systolic and diastolic blood pressure, fasting blood glucose, serum creatinine, cystatin-C, serum VEGF and serum PEDF concentrations (P<0.05). Multivariate logistic regression analysis showed that the higher level of serum VEGF (odds ratio: 1.393; 95%CI=1.011-1.920, P=0.042) was the independent risk factor for VCI in CSVD; and relative lower expression of serum PEDF (odds ratio: 0.521, 95%CI=0.384-0.707, P=0.000) was the independent protective factor for VCI in CSVD patients. ROC curve analysis showed that the area under the curve of serum VEGF concentration combined with PEDF concentration to predict VCI in CSVD was 0.769 (95%CI=0.705-0.832, P<0.001), the sensitivity was 0.911, and the specificity was 0.612.The best cutoff values were 128.61 pg/mL and 100.95 ng/mL, which were of good predictive value. Conclusion: The concentrations of serum VEGF and PEDF are significantly correlated with VCI in CSVD patients, and the levels of serum VEGF and PEDF are expected to serve as the alternative indicators for the assessment of VCI in CSVD.
