Vascular contribution to cognitive impairment and dementia (VCID) is a clinical label encompassing a wide range of cognitive disorders progressing from mild to major vascular cognitive impairment (VCI), which is also defined as vascular dementia (VaD). VaD diagnosis is mainly based on clinical and imaging findings. Earlier biomarkers are needed to identify subjects at risk to develop mild VCI and VaD. In the present meta-analysis, we comprehensively evaluated the role of inflammatory biomarkers in differential diagnosis between VaD and Alzheimer’s disease (AD), and assessed their prognostic value on predicting VaD incidence. We collected literature until January 31, 2021, assessing three inflammatory markers [interleukin(IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-α] from blood or cerebrospinal fluid (CSF) samples. Thirteen cross-sectional and seven prospective studies were included. Blood IL-6 levels were cross-sectionally significantly higher in people with VaD compared to AD patients (SMD: 0.40, 95% CI: 0.18 to 0.62) with low heterogeneity (I²: 41%, p = 0.13). Higher IL-6 levels were also associated to higher risk of incident VaD (relative risk: 1.28, 95% CI: 1.03 to 1.59, I²: 0%). IL-6 in CSF was significantly higher in people with VaD compared to healthy subjects (SMD: 0.77, 95% CI: 0.17 to 1.37, I²: 70%), and not compared to AD patients, but due to limited evidence and high inconsistency across studies, we could not draw definite conclusion. Higher blood IL-6 levels might represent a useful biomarker able to differentiate people with VaD from those with AD and might be correlated with higher risk of future VaD.

血管对认知障碍和痴呆的贡献 (VCID) 是一个临床标签，涵盖范围广泛的认知障碍，从轻度到重度血管性认知障碍 (VCI)，也被定义为血管性痴呆 (VaD)。VaD的诊断主要基于临床和影像学表现。需要更早的生物标志物来识别有患轻度 VCI 和 VaD 风险的受试者。在本荟萃分析中，我们全面评估了炎症生物标志物在 VaD 和阿尔茨海默病 (AD) 鉴别诊断中的作用，并评估了它们在预测 VaD 发病率方面的预后价值。我们收集了截至 2021 年 1 月 31 日的文献，评估了血液或脑脊液 (CSF) 样本中的三种炎症标志物 [白细胞介素 (IL)-6、C 反应蛋白 (CRP)、肿瘤坏死因子 (TNF)-α]。纳入了 13 项横断面研究和 7 项前瞻性研究。与异质性低的 AD 患者相比，VaD 患者的血液 IL-6 水平在横断面上显着高于 AD 患者（SMD：0.40，95% CI：0.18 至 0.62）。I ² : 41%, p  = 0.13)。较高的 IL-6 水平也与较高的 VaD 风险相关（相对风险：1.28，95% CI：1.03 至 1.59，I ²：0%）。与健康受试者相比，VaD 患者 CSF 中的 IL-6 显着更高（SMD：0.77，95% CI：0.17 至 1.37，I ²：70%），与 AD 患者相比，但由于证据有限和高由于研究不一致，我们无法得出明确的结论。较高的血液 IL-6 水平可能代表一种有用的生物标志物，能够区分 VaD 患者和 AD 患者，并且可能与未来 VaD 的较高风险相关。