AUTHOR=Yang Ying-hao , Li Shan-shan , Wang Yun-chao , Yu Lu-lu , Zhu Hang-hang , Wu Jing-hao , Yu Wen-kai , An Lu , Yuan Wen-xin , Ji Yan , Xu Yu-ming , Gao Yuan , Li Yu-sheng 

TITLE=Correlation between neutrophil gelatinase phase lipocalin and cerebral small vessel disease

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1177479

DOI=10.3389/fneur.2023.1177479

ISSN=1664-2295

ABSTRACT=Background: Cerebral small vessel disease (CSVD) is common in the elderly population. Neutrophil gelatinase-associated lipocalin (NGAL) has been found to be closely related to cardiovascular and cerebrovascular diseases. NGAL causes pathological changes, such as damage to the vascular endothelium, by causing inflammation and results in other related diseases. The purpose of this study was to investigate whether serum NGAL levels could predict disease severity in patients with CSVD.
Methods: The patients with CSVD who visited the Neurology Department of the First Affiliated Hospital of Zhengzhou University between January 2018 and June 2022 were prospectively included. The total CSVD burden score was calculated using whole-brain magnetic resonance imaging (MRI), and the patients were divided into mild group (total CSVD burden score < 2 points) and severe group (total CSVD burden score ≥ 2 points). Age, sex, height, smoking and drinking history, past medical history, and serological results of patients were collected to perform the univariate analysis. Multivariate logistic regression was used to analyze the risk factors that affect CSVD severity. The multiple linear regression method was used to analyze which individual CSVD markers (periventricular white matter hyperintensities, deep white matter hyperintensities, lacune, cerebral microbleed) play a role in the association between total CSVD burden score and NGAL.
Results: A total of 427 patients with CSVD (140 in the mild group and 287 in the severe group) were included in the study. Multivariate Logistic regression analysis showed that the following factors were significantly associated with CSVD severity: male sex (odds ratio [OR], 1.912; 95% confidence interval [CI], 1.150-3.179); age (OR, 1.046; 95%CI, 1.022-1.070), history of cerebrovascular disease (OR, 3.050; 95%CI, 1.764-5.274), serum NGAL level (OR, 1.005; 95%CI, 1.002–1.008), and diabetes (OR, 2.593; 95%CI, 1.424-4.722). A multivariate linear regression shows that periventricular white matter hyperintensities and cerebral microbleed are associated with serum NGAL concentrations (P <0.05).
Conclusions: Serum NGAL level is closely related to CSVD severity and is a risk factor for the burden of CSVD brain damage. Serum NGAL has high specificity in reflecting the severity of CSVD.