Clinical analysis of the effect of metabolic syndrome on cognitive function after acute ischemic stroke
10.3760/cma.j.issn.0254-9026.2019.10.020
- VernacularTitle: 代谢综合征对急性缺血性脑卒中后认知功能影响的临床分析
- Author:
Pan LI
1
,
2
,
3
;
Yuying ZHOU
1
,
2
,
3
;
Yan WANG
1
,
2
,
3
;
Miao ZHANG
1
,
2
,
3
;
Yuan CHEN
1
,
2
,
3
;
Hui LIU
1
,
2
,
3
;
Huihong ZHANG
1
,
2
,
3
Author Information
1. Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300350, China
2. Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgery Institute, Tianjin Huanhu Hospital, Tianjin 300350, China
3. Tianjin Dementia Research Institute, Tianjin 300350, China
- Publication Type:Journal Article
- Keywords:
Metabolic syndrome;
Stroke;
Cognition;
Neuropsychological tests;
Movement disorders
- From:
Chinese Journal of Geriatrics
2019;38(10):1142-1147
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of metabolic syndrome(MetS) and its individual components on cognitive impairment and neurological dysfunction in patients after acute ischemic stroke.
Methods:A total of 733 patients with acute ischemic stroke aged 60 to 83 years admitted in Tianjin Huanhu hospital from January 2010 to May 2018 were enrolled in this cross-sectional study.The patients were divided into the non-metabolic syndrome(non-MetS) group and the metabolic syndrome(MetS) group according to the diagnostic criteria of metabolic syndrome.Cognitive functions were evaluated by using the Montreal Cognitive Assessment(MoCA) and Mini-Mental State Examination(MMSE). Neuropsychiatric behavior was assessed by using the Neuropsychiatric Inventory(NPI) questionnaire.Emotional state was examined according to the 21-item Hamilton Depression Rating Scale(HAMD-21). The degree of neurological impairment after stroke was evaluated by using the National Institutes of Health Stroke Scale(NIHSS). The activity of daily living was evaluated by Barthel index and the Activity of Daily Living(ADL) scale.The overnight fasting blood samples were obtained in order to determine biochemical indicators.
Results:The average age of first-onset of ischemic stroke was earlier, and the body mass index(BMI) was higher in the MetS group than in the non-MetS group(P<0.05). The levels of high sensitivity C-reactive protein(hs-CRP), total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), homocysteine(Hcy), fasting plasma glucose(FPG) and haemoglobin A1c(HbA1c) were higher, and the level of high-density lipoprotein cholesterol(HDL-C) was lower in the MetS group than in the non-MetS group(P<0.05). In addition, the proportions of patients with hypertension, type 2 diabetes and smokers were higher in the MetS group than in the non-MetS group(P<0.05). The scores of MMSE, MoCA and BI were lower and the scores of NIHSS, NPI-Q and HADM-21 were higher in the MetS group than in the non-MetS group.MetS could increase the risk of cognitive impairment in patients after acute ischemic stroke(OR=3.169, 95% CI: 1.110-9.048). After adjusting for socio-demographic and clinical covariates, the estimated OR value for increasing the risk of cognitive impairment was further increased in MetS(OR=4.741, 95% CI: 2.027-7.427). Furthermore, the increased numbers of MetS components were significantly associated with the cognitive impairment in patients after stroke.With the increasing number of MetS components, the scores of MoCA and BI were decreased, and the scores of ADL, NIHSS, NPI-Q, HADM-21 and Hachinski ischemic scale(HIS) were increased.With the increasing number of MetS components, the degree of neurological impairment and the risk of injury were increased.
Conclusions:MetS is associated with the decline of cognitive function, neuromotor dysfunction and the increased risk for neuropsychological disorders in patients after acute ischemic stroke.
