Erythrocytes Are an Independent Protective Factor for Vascular Cognitive Impairment in Patients With Severe White Matter Hyperintensities

Xi Tao; Hang Zhou; Danheng Mo; Wenjie Zhang; Zihan Chang; Yiheng Zeng; Yuqi Luo; Siyuan Wu; Wenjing Tang; Chen Yang; Qing Wang

doi:10.3389/fnagi.2022.789602

Erythrocytes Are an Independent Protective Factor for Vascular Cognitive Impairment in Patients With Severe White Matter Hyperintensities

Front Aging Neurosci. 2022 Feb 18:14:789602. doi: 10.3389/fnagi.2022.789602. eCollection 2022.

Authors

Xi Tao^{1

2}, Hang Zhou¹, Danheng Mo^{1

2}, Wenjie Zhang¹, Zihan Chang¹, Yiheng Zeng¹, Yuqi Luo¹, Siyuan Wu², Wenjing Tang², Chen Yang², Qing Wang¹

Affiliations

¹ Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
² Department of Neurological Rehabilitation, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China.

Abstract

Background and Purpose: Hemoglobin is one of the main proteins in erythrocytes. There are significant correlations between low hemoglobin and white matter hyperintensities (WMH) and cognitive impairment. This study explored whether erythrocytopenia has predictive value for vascular cognitive impairment (VCI) in patients with WMH. Method: We conducted a cross-sectional study of 302 patients, including 62 with cerebral small vessel disease and 240 with stroke. Basic demographic data and fasting blood were collected. First, all patients were divided into normal cognition (NC), mild VCI (mVCI), and severe VCI (sVCI) groups (subgroups later) based on cognitive behavior scores. Second, all patients were divided into mild WMH (mWMH) and severe WMH (sWMH) groups based on Fazekas scores. The differences in blood markers between different groups or subgroups with different cognitive levels were analyzed by univariate analysis. Then, binary logistic regression was used to analyze the diagnostic value of erythrocyte counts for VCI in the sWMH group, and ordinal logistic regression was used to analyze the predictive value of multiple variables for different cognitive levels. Results: Univariate analysis showed that erythrocytes, hemoglobin, high-sensitivity C-reactive protein, retinol binding protein and prealbumin were potential blood markers for different cognitive levels in sWMH patients. Among them, erythrocytopenia has good predictive value for the diagnosis of mVCI (AUC = 0.685, P = 0.008) or sVCI (AUC = 0.699, P = 0.003) in patients with sWMH. Multivariate joint analysis showed that erythrocytes were an independent protective factor reducing the occurrence of VCI in patients with sWMH (OR = 0.633, P = 0.045). Even after adjusting for age, there was still a significant difference (P = 0.047). Conclusion: Erythrocytes are an independent protective factor for VCI in patients with sWMH. Promoting hematopoietic function may have potential value for prevention of cognitive decline in patients with cerebrovascular disease.

Keywords: cerebrovascular disease; erythrocyte; high-sensitivity C-reactive protein; prealbumin; retinol binding protein; vascular cognitive impairment; white matter hyperintensities.