Associations of plasma homocysteine and lipoprotein-associated phospholipase A2 levels with dementia

Abstract

Objective To investigate the associations of plasma homocysteine (Hcy) and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels with dementia. Methods The patients with dementia admitted to hospital were enrolled retrospectively. They were divided into a vascular dementia (VaD) group, a mixed dementia (MD) group, and an Alzheimer's disease (AD) group according to the Hachinski Ischemic Score, and the dementia severity was further divided into a mild group, a moderate group and a severe group according to the Mini-Mental State Examination. The non-demented patients hospitalized during the same period were selected as controls. The demographics, vascular risk factors, and plasma Hcy and Lp-PLA2 levels in each group were compared. Logistic regression analysis was used to determine the independent associations of the plasma Hcy and Lp-PLA2 levels with the risk of dementia and severity. Results A total of 125 patients with dementia were enrolled, including 52 (41.6%) in the VaD group, 21 (16.8%) in the MD group, and 53 (41.6%) in the AD group. There were 49 patients (39.2%) in the mild group, 51 (40.8%) in the moderate group, and 25 (20%) in the severe group. A total of 40 non-demented patients were enrolled as control group. The plasma Hcy and Lp-PLA2 levels in VaD, MD and AD groups were significantly higher than those in the control group (all P<0.001). Multivariable logistic regression analysis showed that the advanced age (odds ratio[OR] 1.12, 95% confidence interval [CI] 1.03-1.21; P=0.010), high plasma Hcy level (OR 1.44, 95% CI 1.21-1.71; P<0.001), high Lp-PLA2 level (OR 1.01, 95% CI 1.00-1.02; P=0.006 ), and previous stroke (OR 4.29, 95% CI 1.50-12.36; P=0.007) were the independent risk factors for dementia; high Hcy level (OR 1.48, 95% CI 1.21-1.82; P<0.001, high Lp-PLA2 level (OR 1.01, 95% CI 1.00-1.03; P=0.002), and previous stroke (OR 152.78, 95% CI 20.41- 999.97; P<0.001) were the independent risk factors for VaD; advanced age (OR 1.10, 95% CI 1.02-1.17; P=0.008) and high Hcy level (OR 1.41, 95% CI 1.25-1.58; P<0.001) were the independent risk factor for severe dementia. Conclusions The increased plasma Hcy and Lp-PLA2 levels are associated with dementia. Reducing the plasma Hcy and Lp-PLA2 levels may be beneficial to the treatment and prevention of dementia. Key words: Dementia; Dementia, Vascular; Alzheimer Disease; Homocysteine; 1-Alkyl-2-acetylglycerophosphocholine Esterase; Biomarkers