Relationship Among Homocysteine, Inflammation and Cognitive Impairment in Patients with Acute Ischemic Stroke and Transient Ischemic Attack
第一作者:LingYunCui
通讯作者:Yongjun Wang
2021-12-11
发表杂志:Neuropsychiatric Disease and Treatment
发表类型: Article
影响因子(IF): 2.57
PMID: 34924754 Pubmed原文链接 全文下载
Post stroke cognitive impairment (PSCI) is an important factor that seriously affects the quality of life and survival time of patients.Physical or language disabilities in patients with mild AIS or TIA are relatively mild, so the impact of cognitive impairment on their quality of life is relatively more prominent.High homocysteine is one of the independent risk factors for cognitive decline, dementia and Alzheimer's disease in the elderly,but there is on prospective national registry study to explore the relationship between cognitive impairment and sleep disorders after AIS or TIA in an inpatient population in China.We aim to assess the Relationship between Homocysteine and cognitive impairment after stroke or TIA in Chinese population,and further determine the predictive role of homocysteine.
Cognitive impairment is assessed by MOCA.Homocysteine is categorized into 4 groups by quartile. Univariate and multivariate logistic regression analyses are used to assess the association between homocysteine levels and cognitive impairment after Stroke or TIA.ROC curve is used to evaluate the predictive effect of homocysteine on cognitive impairment after stroke or TIA.
High inflammatory levels increase the risk of cognitive impairment in HHcy patients after AIS and TIA
We enrolled 1466 patients with a median age of 62 (54–70) years old, including 895 (61.05%) patients with elevated Hcy levels, 466 (31.79%) with increased hsCRP concentrations, and 755 (51.50%) with PSCI. In the group of patients with hyperhomocysteinemia (HHcy), higher hsCRP levels were related to cognitive impairment, whether or not adjusted for multiple potential confounders (crude OR: 1.71,95% CI: 1.29–2.27, p < 0.01; adjusted OR: 1.42, 95% CI: 1.04–1.93, p = 0.03). No significant interactions for the impact on PSCI were observed in subgroups stratified by age, sex or Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification (P interaction > 0.05 for all).