Objective:To analyze the association of physical activity (PA) levels with the cognitive function and mental health among health check-up population.Methods:It is a cross-sectional study. The data from 869 health check-up population were consecutively collected from Beijing Tiantan Hospital, Capital Medical University between January 1, 2023 and December 31, 2023, including sex, age, body mass index (BMI), waist to hip ratio (WHR), educational years, medical history and personal history. The Global Physical Activity Questionnaire (GPAQ) was used to evaluate the PA levels, the Montreal Cognitive Assessment (MoCA) was performed to assess the global cognitive function, and the Patient Health Questionnaire 9 (PHQ-9) and the 7-item Generalized Anxiety Disorder (GAD-7) was used to screen for depression and generalized anxiety, respectively. Laboratory examination of lipid metabolism-related biomarkers included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), lipoprotein(a) [Lp(a)], apolipoprotein A-1 (ApoA1), apolipoprotein B (ApoB), small dense low-density lipoprotein (sdLDL) and remnant cholesterol (RC). The differences in general data, scale evaluation, and lipid metabolism-related biomarkers were compared among three groups [sufficiently active group:≥600 (metabolic equivalent,MET)-min/week, insufficiently active group: 1-599 MET-min/week, and inactive group: 0 MET-min/week]. The multiple linear regression was used to analyze the correlation between the PA or sitting time and MoCA, PHQ-9 or GAD-7 scores, respectively.Results:A total of 869 health check-up population was finally included, with the age of (51.22±10.09) years old; among these, 545 patients were men (62.72%), 324 cases were women (37.28%), 153 cases with cognitive impairment (17.61%). Participants in sufficiently active group had lower WHR [(0.88±0.07) vs (0.89±0.07)], sitting time [7.00 (4.00, 10.00) vs 10.00 (6.00, 12.00) h], PHQ-9 [2.00 (0, 5.00) vs 3.00 (0, 7.00) scores], GAD-7 [2.00 (0, 4.00) vs 3.00 (0, 6.00) scores], and sdLDL levels [0.93 (0.60, 1.32) vs 1.09 (0.70, 1.45) mmol/L] than those in inactive group (all corrected P<0.05). Population in sufficiently active group was older than those in insufficiently active group[(52.10±9.90) vs (49.88±9.88) years], and had lower BMI [(25.73±3.82) vs (26.13±3.54) kg/m 2], WHR [(0.88±0.07) vs (0.90±0.07)], proportion in medical history of alcohol consumption (14.46% vs 23.61%), sitting time [7.00 (4.00, 10.00) vs 9.15 (6.00, 12.00) h], PHQ-9 [2.00 (0, 5.00) vs 3.00 (0, 5.00) scores], and GAD-7 [2.00 (0, 4.00) vs 2.00 (0, 5.00) scores] than those in insufficiently active group (all corrected P<0.05). The sitting time ( β=-0.081, 95% CI:-0.134, -0.028), age ( β=-0.089, 95% CI:-0.111, -0.067), and WHR ( β=-7.069, 95% CI:-11.667, -2.472) were negatively correlated with the MoCA scores; the PA levels ( β=-1.06×10 -4, 95% CI:-1.06×10 -4, -3.05×10 -5), age ( β=-0.077, 95% CI:-0.106, -0.049), BMI ( β=-0.098,95% CI:-0.192, -0.005), educational years ( β=-0.090, 95% CI:-0.151, -0.029), and HDL-C levels ( β=-4.236, 95% CI:-6.171, -2.301) were negatively correlated with the elevation of PHQ-9 scores, while the PA ( β=-9.14×10 -6, 95% CI:-6.76×10 -6, 8.58×10 -5), age ( β=-0.089, 95% CI:-0.118, -0.060), and HDL-C levels ( β=-3.442, 95% CI:-5.403, -1.480) were negatively correlated with the of GAD-7 scores (all P<0.05). Conclusion:Decreased physical activity level significantly increases the risk of depression, anxiety, and cognitive impairment among health check-up population, suggesting that early screen for physical activity and active intervention for exercise and sedentary behavior are of great significance for preventing cognitive decline, anxiety and depression.

Objective:To investigate the correlation between the ratio of apolipoprotein B to apolipoprotein A-I (ApoB/ApoA-I) and unstable carotid plaque in a neurologically healthy population receiving health check-ups.Methods:This cross-sectional study consecutively enrolled 1 149 neurologically healthy individuals who underwent physical examinations at the Health Management Centre of Beijing Tiantan Hospital, Capital Medical University, from October 2021 to September 2022. All eligible participants completed standardized questionnaires, physical examinations and laboratory tests. Laboratory tests of lipid metabolism-related biomarkers included total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), ApoA-I, and ApoB; non-high-density lipoprotein cholesterol and the ApoB/ApoA-I ratio were subsequently calculated. The carotid plaque stability was evaluated using superb microvascular imaging technology. The participants were classified into unstable plaque group (341 cases) and stable plaque group (808 cases) according to the presence or absence of intraplaque neovascularization. The univariate and multivariate logistic regression analyses were used to explore the correlation between the ApoB/ApoA-I ratio and unstable carotid plaques.Results:The study enrolled 1 149 participants totally, with a median age of 57 (49-63) years, including 771 males (67.10%) and 378 females (32.90%), and 341 cases (29.68%) were found with unstable carotid plaques. The unstable plaque group had a higher proportion of males, smoking history, diabetes history, along with higher waist-to-hip ratio and ApoB/ApoA-I ratio compared to the stable plaque group [76.54% vs 63.12%, 33.43% vs 22.77%, 19.06% vs 13.37%, 0.91 (0.85, 0.94) vs 0.89 (0.84, 0.93), 0.64 (0.51, 0.76) vs 0.59 (0.48, 0.72)], while HDL-C and ApoA-I levels were lower [1.39 (1.19, 1.63) vs 1.44 (1.24, 1.66) mmol/L, 1.43 (1.29, 1.60) vs 1.51 (1.36, 1.68) g/L] (all P<0.05). An elevated ApoB/ApoA-I ratio was positively associated with the risk of unstable carotid plaque ( OR=1.61, 95% CI: 1.13-2.29, P=0.008; P for trend<0.001). After adjusting for age, gender, waist-to-hip ratio, history of hypertension, history of diabetes, dyslipidemia, cardiovascular disease, history of smoking and estimated glomerular filtration rate, the positive association between elevated ApoB/ApoA-I ratio and the risk of unstable carotid plaque remained significant ( OR=1.48, 95% CI: 1.01-2.16, P=0.044; P for trend=0.004). Conclusion:In a neurologically healthy population receiving health check-ups, an elevated ApoB/ApoA-I ratio may increase the risk of unstable carotid plaque.

Objective:To analyze the mediating effect of the inflammation on the sex differences in cognitive function among middle-aged and elderly individuals receiving health checkups.Methods:This cross-sectional study consecutively collected data from 757 middle-aged and elderly individuals receiving health checkups at Beijing Tiantan Hospital, Capital Medical University between January 1, 2023 and December 31, 2023. The gender, age, body mass index (BMI), waist to hip ratio (WHR), educational years, medical history and personal history were collected. The Montreal Cognitive Assessment (MoCA) were performed to assess the cognitive function. Inflammation indicators included the single blood inflammatory markers [white blood cell (WBC), high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, and erythrocyte sedimentation rate (ESR)], inflammatory markers derived from blood cell counts, including neutrophil-lymphocyte ratio (NLR), derived neutrophil-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-monocyte to lymphocyte ratio (NMLR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and aggregate index of systemic inflammation (AISI); and inflammatory markers derived from blood cell counts and high-density lipoprotein cholesterol (HDL-C), including neutrophil to HDL-C ratio (NHR), monocyte to HDL-C ratio (MHR), lymphocyte to HDL-C ratio (LHR), and platelet to HDL-C ratio (PHR) were all recorded. The simple mediation effect model in the SPSS 29.0 PROCESS macro was used to analyze the mediation effects of the inflammation indicators on the gender differences in cognitive function among middle-aged and elderly individuals receiving health checkups.Results:Among the 757 health checkup population in the final analysis, 466 were male (61.56%), and 291 were female (38.44%), with a mean age of (54.24±8.42) years. The male had higher BMI, WHR, educational years, frequency of hypertension and diabetes mellitus, MoCA scores, and inflammation indicators, including hs-CRP, WBC, NLR, MLR, NMLR, SIRI, AISI, NHR, MHR, LHR and PHR than those in the female [(26.41±3.20) vs (24.32±3.06) kg/m 2, (0.93±0.05) vs (0.83±0.06), 12 (9, 16) vs 11 (8, 15) years, 37.77% vs 21.31%, 16.52% vs 8.93%, 26 (24, 28) vs 26 (22, 28) points, 0.81 (0.38, 1.61) vs 0.63 (0.27, 1.63) mg/L, 5.75 (4.96, 6.78) vs 5.08 (4.27, 6.05)×10 9/L, 2.06 (1.67, 2.64) vs 1.87 (1.50, 2.37), 0.21 (0.17, 0.25) vs 0.17 (0.13, 0.21), 2.26 (1.84, 2.88) vs 2.02 (1.68, 2.55), 0.71 (0.51, 1.01) vs 0.49 (0.35, 0.67), 153.43 (108.91, 220.63) vs 113.34 (78.06, 164.27), 0.16 (0.12, 0.20) vs 0.11 (0.08, 0.14), 0.02 (0.01, 0.02) vs 0.01 (0.01, 0.01), 0.08 (0.06, 0.01) vs 0.06 (0.04, 0.07), 9.33 (7.82, 11.33) vs 8.36 (6.37, 10.21)] (all P<0.05). ESR and dNLR levels in the male were both lower than those in the female [6 (2, 11) vs 11 (6, 18) mm/h, 0.87 (0.85, 0.89) vs 0.89 (0.87, 0.91)] (both P<0.05). The MoCA score was negatively correlated with age, WHR, hs-CRP, IL-6, NLR, dNLR, NMLR, SIRI, NHR ( r=-0.355, -0.103, -0.115, -0.085, -0.094, -0.078, -0.093, -0.074, -0.108), and positively correlated with educational years ( r=0.512) (all P<0.05). After adjustment for confounding factors, including age, BMI, WHR, educational years, hypertension, and diabetes mellitus, dNLR and NHR mediated 13.11% and 12.80% association between gender and MoCA scores, respectively; after adjustment for above-mentioned confounders adding hs-CRP and IL-6, dNLR mediated 13.07% association between gender and MoCA score (all P<0.05), whereas no significant mediating effect was found of NHR on this association. Conclusions:Inflammation performed potential mediating effect on the association between sex difference and cognitive function among middle-to-old aged health checkup population, and the sex difference in cognitive function was partly mediated by the dNLR and NHR.

Objective:To analyze the association of physical activity (PA) levels with the cognitive function and mental health among health check-up population.Methods:It is a cross-sectional study. The data from 869 health check-up population were consecutively collected from Beijing Tiantan Hospital, Capital Medical University between January 1, 2023 and December 31, 2023, including sex, age, body mass index (BMI), waist to hip ratio (WHR), educational years, medical history and personal history. The Global Physical Activity Questionnaire (GPAQ) was used to evaluate the PA levels, the Montreal Cognitive Assessment (MoCA) was performed to assess the global cognitive function, and the Patient Health Questionnaire 9 (PHQ-9) and the 7-item Generalized Anxiety Disorder (GAD-7) was used to screen for depression and generalized anxiety, respectively. Laboratory examination of lipid metabolism-related biomarkers included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), lipoprotein(a) [Lp(a)], apolipoprotein A-1 (ApoA1), apolipoprotein B (ApoB), small dense low-density lipoprotein (sdLDL) and remnant cholesterol (RC). The differences in general data, scale evaluation, and lipid metabolism-related biomarkers were compared among three groups [sufficiently active group:≥600 (metabolic equivalent,MET)-min/week, insufficiently active group: 1-599 MET-min/week, and inactive group: 0 MET-min/week]. The multiple linear regression was used to analyze the correlation between the PA or sitting time and MoCA, PHQ-9 or GAD-7 scores, respectively.Results:A total of 869 health check-up population was finally included, with the age of (51.22±10.09) years old; among these, 545 patients were men (62.72%), 324 cases were women (37.28%), 153 cases with cognitive impairment (17.61%). Participants in sufficiently active group had lower WHR [(0.88±0.07) vs (0.89±0.07)], sitting time [7.00 (4.00, 10.00) vs 10.00 (6.00, 12.00) h], PHQ-9 [2.00 (0, 5.00) vs 3.00 (0, 7.00) scores], GAD-7 [2.00 (0, 4.00) vs 3.00 (0, 6.00) scores], and sdLDL levels [0.93 (0.60, 1.32) vs 1.09 (0.70, 1.45) mmol/L] than those in inactive group (all corrected P<0.05). Population in sufficiently active group was older than those in insufficiently active group[(52.10±9.90) vs (49.88±9.88) years], and had lower BMI [(25.73±3.82) vs (26.13±3.54) kg/m 2], WHR [(0.88±0.07) vs (0.90±0.07)], proportion in medical history of alcohol consumption (14.46% vs 23.61%), sitting time [7.00 (4.00, 10.00) vs 9.15 (6.00, 12.00) h], PHQ-9 [2.00 (0, 5.00) vs 3.00 (0, 5.00) scores], and GAD-7 [2.00 (0, 4.00) vs 2.00 (0, 5.00) scores] than those in insufficiently active group (all corrected P<0.05). The sitting time ( β=-0.081, 95% CI:-0.134, -0.028), age ( β=-0.089, 95% CI:-0.111, -0.067), and WHR ( β=-7.069, 95% CI:-11.667, -2.472) were negatively correlated with the MoCA scores; the PA levels ( β=-1.06×10 -4, 95% CI:-1.06×10 -4, -3.05×10 -5), age ( β=-0.077, 95% CI:-0.106, -0.049), BMI ( β=-0.098,95% CI:-0.192, -0.005), educational years ( β=-0.090, 95% CI:-0.151, -0.029), and HDL-C levels ( β=-4.236, 95% CI:-6.171, -2.301) were negatively correlated with the elevation of PHQ-9 scores, while the PA ( β=-9.14×10 -6, 95% CI:-6.76×10 -6, 8.58×10 -5), age ( β=-0.089, 95% CI:-0.118, -0.060), and HDL-C levels ( β=-3.442, 95% CI:-5.403, -1.480) were negatively correlated with the of GAD-7 scores (all P<0.05). Conclusion:Decreased physical activity level significantly increases the risk of depression, anxiety, and cognitive impairment among health check-up population, suggesting that early screen for physical activity and active intervention for exercise and sedentary behavior are of great significance for preventing cognitive decline, anxiety and depression.

Objective:To investigate the correlation between the ratio of apolipoprotein B to apolipoprotein A-I (ApoB/ApoA-I) and unstable carotid plaque in a neurologically healthy population receiving health check-ups.Methods:This cross-sectional study consecutively enrolled 1 149 neurologically healthy individuals who underwent physical examinations at the Health Management Centre of Beijing Tiantan Hospital, Capital Medical University, from October 2021 to September 2022. All eligible participants completed standardized questionnaires, physical examinations and laboratory tests. Laboratory tests of lipid metabolism-related biomarkers included total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), ApoA-I, and ApoB; non-high-density lipoprotein cholesterol and the ApoB/ApoA-I ratio were subsequently calculated. The carotid plaque stability was evaluated using superb microvascular imaging technology. The participants were classified into unstable plaque group (341 cases) and stable plaque group (808 cases) according to the presence or absence of intraplaque neovascularization. The univariate and multivariate logistic regression analyses were used to explore the correlation between the ApoB/ApoA-I ratio and unstable carotid plaques.Results:The study enrolled 1 149 participants totally, with a median age of 57 (49-63) years, including 771 males (67.10%) and 378 females (32.90%), and 341 cases (29.68%) were found with unstable carotid plaques. The unstable plaque group had a higher proportion of males, smoking history, diabetes history, along with higher waist-to-hip ratio and ApoB/ApoA-I ratio compared to the stable plaque group [76.54% vs 63.12%, 33.43% vs 22.77%, 19.06% vs 13.37%, 0.91 (0.85, 0.94) vs 0.89 (0.84, 0.93), 0.64 (0.51, 0.76) vs 0.59 (0.48, 0.72)], while HDL-C and ApoA-I levels were lower [1.39 (1.19, 1.63) vs 1.44 (1.24, 1.66) mmol/L, 1.43 (1.29, 1.60) vs 1.51 (1.36, 1.68) g/L] (all P<0.05). An elevated ApoB/ApoA-I ratio was positively associated with the risk of unstable carotid plaque ( OR=1.61, 95% CI: 1.13-2.29, P=0.008; P for trend<0.001). After adjusting for age, gender, waist-to-hip ratio, history of hypertension, history of diabetes, dyslipidemia, cardiovascular disease, history of smoking and estimated glomerular filtration rate, the positive association between elevated ApoB/ApoA-I ratio and the risk of unstable carotid plaque remained significant ( OR=1.48, 95% CI: 1.01-2.16, P=0.044; P for trend=0.004). Conclusion:In a neurologically healthy population receiving health check-ups, an elevated ApoB/ApoA-I ratio may increase the risk of unstable carotid plaque.

Objective:To analyze the mediating effect of the inflammation on the sex differences in cognitive function among middle-aged and elderly individuals receiving health checkups.Methods:This cross-sectional study consecutively collected data from 757 middle-aged and elderly individuals receiving health checkups at Beijing Tiantan Hospital, Capital Medical University between January 1, 2023 and December 31, 2023. The gender, age, body mass index (BMI), waist to hip ratio (WHR), educational years, medical history and personal history were collected. The Montreal Cognitive Assessment (MoCA) were performed to assess the cognitive function. Inflammation indicators included the single blood inflammatory markers [white blood cell (WBC), high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, and erythrocyte sedimentation rate (ESR)], inflammatory markers derived from blood cell counts, including neutrophil-lymphocyte ratio (NLR), derived neutrophil-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-monocyte to lymphocyte ratio (NMLR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and aggregate index of systemic inflammation (AISI); and inflammatory markers derived from blood cell counts and high-density lipoprotein cholesterol (HDL-C), including neutrophil to HDL-C ratio (NHR), monocyte to HDL-C ratio (MHR), lymphocyte to HDL-C ratio (LHR), and platelet to HDL-C ratio (PHR) were all recorded. The simple mediation effect model in the SPSS 29.0 PROCESS macro was used to analyze the mediation effects of the inflammation indicators on the gender differences in cognitive function among middle-aged and elderly individuals receiving health checkups.Results:Among the 757 health checkup population in the final analysis, 466 were male (61.56%), and 291 were female (38.44%), with a mean age of (54.24±8.42) years. The male had higher BMI, WHR, educational years, frequency of hypertension and diabetes mellitus, MoCA scores, and inflammation indicators, including hs-CRP, WBC, NLR, MLR, NMLR, SIRI, AISI, NHR, MHR, LHR and PHR than those in the female [(26.41±3.20) vs (24.32±3.06) kg/m 2, (0.93±0.05) vs (0.83±0.06), 12 (9, 16) vs 11 (8, 15) years, 37.77% vs 21.31%, 16.52% vs 8.93%, 26 (24, 28) vs 26 (22, 28) points, 0.81 (0.38, 1.61) vs 0.63 (0.27, 1.63) mg/L, 5.75 (4.96, 6.78) vs 5.08 (4.27, 6.05)×10 9/L, 2.06 (1.67, 2.64) vs 1.87 (1.50, 2.37), 0.21 (0.17, 0.25) vs 0.17 (0.13, 0.21), 2.26 (1.84, 2.88) vs 2.02 (1.68, 2.55), 0.71 (0.51, 1.01) vs 0.49 (0.35, 0.67), 153.43 (108.91, 220.63) vs 113.34 (78.06, 164.27), 0.16 (0.12, 0.20) vs 0.11 (0.08, 0.14), 0.02 (0.01, 0.02) vs 0.01 (0.01, 0.01), 0.08 (0.06, 0.01) vs 0.06 (0.04, 0.07), 9.33 (7.82, 11.33) vs 8.36 (6.37, 10.21)] (all P<0.05). ESR and dNLR levels in the male were both lower than those in the female [6 (2, 11) vs 11 (6, 18) mm/h, 0.87 (0.85, 0.89) vs 0.89 (0.87, 0.91)] (both P<0.05). The MoCA score was negatively correlated with age, WHR, hs-CRP, IL-6, NLR, dNLR, NMLR, SIRI, NHR ( r=-0.355, -0.103, -0.115, -0.085, -0.094, -0.078, -0.093, -0.074, -0.108), and positively correlated with educational years ( r=0.512) (all P<0.05). After adjustment for confounding factors, including age, BMI, WHR, educational years, hypertension, and diabetes mellitus, dNLR and NHR mediated 13.11% and 12.80% association between gender and MoCA scores, respectively; after adjustment for above-mentioned confounders adding hs-CRP and IL-6, dNLR mediated 13.07% association between gender and MoCA score (all P<0.05), whereas no significant mediating effect was found of NHR on this association. Conclusions:Inflammation performed potential mediating effect on the association between sex difference and cognitive function among middle-to-old aged health checkup population, and the sex difference in cognitive function was partly mediated by the dNLR and NHR.

Objective:To analyze the correlation between related indexes of serum lipid and insulin resistance and cognitive impairment in middle-aged and elderly people with mild cognitive impairment (MCI).Methods:In this cross-sectional study, 262 middle-aged and elderly patients with a Montreal Cognitive Function Scale (MoCA) cognitive score greater than or equal to 18 points who underwent physical examination in the Health Management Center of Beijing Tiantan Hospital Affiliated to Capital Medical University from January 1 to July 31, 2021 were selected as subjects. According to the cognitive function and MoCA score, the patients were divided into MCI group (143 cases) and normal cognition group (119 cases). Basic data, fasting blood glucose, triglyceride (TG), total cholesterol, apolipoprotein E(ApoE) genotype and other clinical indicators were collected. Hypothesis test was used to compare the differences in basic data, related indicators of blood lipid and insulin resistance between the two groups. Spearman correlation analysis was used to analyze the correlation between related indicators of blood lipid and insulin resistance and MoCA score in the two groups.Results:The age and the proportion of patients with hypertension, coronary heart disease and diabetes in the MCI group were all significantly higher than those in normal cognition group [(54.83±8.29) vs (50.76±6.34) years, 37.76% vs 31.93%, 4.20% vs 0.84%, 16.08% vs 8.40%] (all P<0.05). The elevation of serum TG ( r=-0.50, 95% CI:-0.88--0.12), TG glucose product index (TyG) ( r=-0.75, 95% CI:-1.29--0.20) and TG to high-density lipoprotein cholesterol ratio (TG/HDL-C) ( r=-0.52, 95% CI:-0.91--0.13) were all negatively correlated with MoCA score (all P<0.05). After adjusting for age and gender, the elevation of TG ( r=-0.39, 95% CI:-0.75--0.31) and TG/HDL-C ( r=-0.43, 95% CI:-0.80--0.05) were both still negatively correlated with MoCA score (both P<0.05). There was no significant correlation between all indexes and MoCA scores in the normal cognition group (all P>0.05). The elevated TG was negatively correlated with MoCA score in the MCI group ( r=-0.70, 95% CI:-1.23-0.16, P=0.017). There was no significant correlation between elevated TG and MoCA score in patients carrying ApoE ε2 and ApoE ε3 genotypes in MCI group (all P>0.05). Conclusion:Elevated related indexes of blood lipids and insulin resistance are negatively correlated with cognitive scores in middle-aged and elderly people with MCI, and it′s more obvious in patients with ApoE ε4 genotype.

Objective:To investigate the association of Subclinical Carotid AtheroSclerosis (SCAS) and prediabetes or Diabetes Mellitus (DM)in the healthy people.Methods:From September 2018 to June 2019, participants who underwent physical examination in the Health Management Center of Beijing Tiantan Hospitial were enrolled consecutively. The baseline characters were collected prospectively. Carotid Ultrasound was evaluated by radiologists according to the standard operating protocol. Univariable analysis and multivariable logistic analysis were used to estimate the association of prediabetes or DM with SCAS.Results:Totally 401 participants were eligible and enrolled. The mean age was (52.2±10.4) years and 43.7% (252/401) of them were females. The prevalence of DM and SCAS were 16.4% (66/401) and 48.9% (196/401) respectively. In the univariate analysis, elder age (≥60 years old) ( OR=5.93, 95% CI: 3.86-9.09, P<0.001), hypertension ( OR=2.76, 95% CI: 1.84-4.15, P<0.01), prediabetes( OR=1.67, 95% CI: 1.08-2.58, P<0.05) and DM ( OR=3.60, 95% CI: 1.97-6.58, P<0.01), cigarettes smoking ( OR=2.64, 95% CI: 1.82-3.81, P<0.001), lower HDLlevel<1.04 mmol/L ( OR=1.58, 95% CI: 1.04-2.42, P<0.001) and hyperhomocysteinemia (≥15 μmol/L)( OR=1.69, 95% CI: 1.17-4.04, P<0.01) were associated with higher prevalence of SCAS. On the contrary, female sex ( OR=0.53, 95% CI: 0.39-0.74, P<0.001) was associated with lower prevalence of SCAS. In the multivariable logistic analysis, elder age(≥60 years old) ( OR=6.04, 95% CI: 3.13-11.7, P<0.01), hypertension ( OR=2.14, 95% CI: 1.13-3.87, P<0.05), cigarettes smoking ( OR=2.19, 95% CI: 1.21-3.98, P<0.05) and DM ( OR=2.32, 95% CI: 1.16-4.67, P<0.05) were associated with SCAS independently. The association between prediabetes and SCAS was not statistically significant. Conclusions:DM is independently associated with SCAS in neurological healthy people, while prediabetes tended to increase the risk of SCAS.

Objective To explore the association between estimated glomerular filtration rate (eGFR) and prognosis of acute ischemic stroke (AIS) patients who were treated by intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA).Methods We consecutively screened AIS patients who were treated by intravenous thrombolysis with rt-PA from January 2006 to September 2016 in Tangshan Gongren Hospital.According to eGFR value of patients at admission,the eligible patients were divided into two groups:normal eGFR group (eGFR ≥ 90 ml ? min-1 ? 1.73 m-2) and decreased eGFR group (eGFR ＜ 90 ml? min-1 ? 1.73 m-2).The incidence of symptomatic intracerebral hemorrhage (SICH),early neurological deterioration (END) at 24 hours and seven days after thrombolysis,mortality within seven days and 90 days,and excellent recovery at 90 days were compared between the two groups.The OR with 95％ CI and the adjusted OR with 95％ CI were analyzed by univariate and multivariate Logistic regression models.Results A total of 258 patients were enrolled,including 182 cases in the normal eGFR group and 76 cases in the decreased eGFR group.After adjusting for the potential confounders,multivariate Logistic regression analysis showed that the rates of SICH (13.2％ (10/76) vs 3.3％ (6/182),OR =3.859,95％ CI 1.313-11.341),END at 24 hours (21.1％ (16/76) vs 8.2％ (15/182),OR =2.958,95％ CI 1.347-6.495) and seven days (32.9％ (25/76) vs 12.6％ (23/182),OR =3.129,95％ CI 1.555-6.293),mortality within seven days (22.4％ (17/76) vs 6.0％ (11/182),OR =4.079,95％ CI 1.588-10.477) and 90 days (23.7％ (18/76) vs 9.9％ (18/182),OR =2.457,95％ CI 1.050-5.749) were higher in the decreased eGFR group than in the normal eGFR group.On the other hand,the chance of excellent recovery at 90 days (22.4％ (17/76) vs 43.4％ (79/182),OR =0.435,95％ CI 0.229-0.824) was less in the decreased eGFR group than in the normal eGFR group.Conclusion Decreased eGFR may not only increase the risks of SICH,END and death,but also reduce the chance of 90-day excellent recovery in AIS patients after intravenous thrombolysis with rt-PA.

Objective To investigate the influencing factors of in-hospital delay using alteplase for intravenous thrombolytic therapy in patients with acute ischemic stroke.Methods From January 2006 to May 2015,220 consecutive patients with acute ischemic stroke admitted to the Department of Neurology,Tangshan Gongren Hospital Affiliated to North China University of Science and Technology were enrolled retrospectively.They all received alteplase for intravenous thrombolytic therapy.Their mean National Institutes of Health Stroke Scale (NIHSS) score on admission was 16±8.According to door-to-needle time (DNT),they were divided into either a delay group (DNT >60 min;n=151) or a non-delay group (DNT ≤60 min;n=69).The baseline data,laboratory tests,onset-to-door (OTD) time,imaging,and etiology classification of trial of org 10172 in acute stroke treatment (TOAST) of both groups were recorded.Univariate analysis was performed on both groups,and further multivariate logistic analysis was performed.Results (1) The proportion of the past history of transient ischemic attack,blood glucose level on admission,time from onset to hospital in the non-delay group were significantly higher than those of the delay group.There were significant differences between the two groups (43.5%[30/69] vs.3.3%[5/151],7.9±3.0 mmol/L vs.6.9±2.1 mmol/L,95±53 min vs.80±34 min,all P<0.05).There were significant differences in the constituent ratio of TOAST classification between the two groups (P<0.05).There were no significant differences in other baseline data and clinical features between the two groups (all P>0.05).(2) Multivariate Logistic regression analysis showed that the risks of patients with the past history of transient ischemic attack (OR,0.330,95%CI 0.109-0.998,P=0.046),elevated blood glucose levels on admission (OR,0.775,95%CI 0.657-0.914,P=0.005),prolonged onset-to-door time (OR,0.648,95%CI 0.504-0.831,P=0.013),internal carotid artery lesions (OR,0.192,95%CI 0.038-0.960,P=0.044) for occurring in-hospital delay after thrombolysis were low.Systolic pressure on admission(OR,1.275,95%CI 1.091-1.491,P=0.027)and cardioembolism(OR,3.892,95%CI 1.661-9.112,P=0.006) for occurring in-hospital delay after thrombolysisin were high.Conclusion The patients with past history of transient ischemic attack,higher blood glucose,prolonged onset-to-door time,and having internal carotid artery lesions may be cause the attention of family members and doctors,and were less prone to having thrombolytic in-hospital delay,whereas those with higher systolic blood pressure on admission and cardioembolism were prone to having in-hospital delay.