Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing.
China National Clinical Research Center for Neurological Diseases, Beijing.
Eur J Neurol. 2018 Jan;25(1):185-191. doi: 10.1111/ene.13497. Epub 2017 Nov 17.
The association between oxidized low-density lipoprotein (oxLDL) and cognitive impairment is unclear. This study aimed to investigate the potential association between oxLDL and cognitive impairment among patients with acute ischemic stroke.
We measured the levels of oxLDL and recorded the Mini-Mental State Examination (MMSE) score in patients with acute ischemic stroke who were recruited from the Study of Oxidative Stress in Patients with Acute Ischemic Stroke. Cognitive impairment was defined as an MMSE score of <24. The association between oxLDL and cognitive impairment was assessed by multivariate logistic or linear regression analysis. Other clinical variables of interest were also studied.
A total of 3726 patients [1287 (34.54%) female] were included in this study, with a mean age of 63.62 ± 11.96 years. After adjusting for potential confounders in our logistic regression model, each SD increase in oxLDL was associated with a 26% increase in the prevalence of cognitive impairment (odds radio, 1.26; 95% confidence interval, 1.13-1.39; P < 0.0001). Similarly, higher oxLDL was associated with lower MMSE scores, with a 0.56-point decrease in MMSE score for every SD increase in oxLDL in a linear regression analysis (β = -0.56; 95% confidence interval, -0.81 to -0.32; P < 0.0001). There were no significant interactions between oxLDL and age, sex or education levels for cognitive impairment (all interactions, P > 0.05).
Elevated levels of oxLDL were associated with a higher prevalence of cognitive impairment in patients with ischemic stroke.
氧化型低密度脂蛋白(oxLDL)与认知障碍的关系尚不清楚。本研究旨在探讨急性缺血性脑卒中患者 oxLDL 与认知障碍之间的潜在关联。
我们测量了急性缺血性脑卒中患者 oxLDL 的水平,并记录了他们的简易精神状态检查(MMSE)评分。认知障碍定义为 MMSE 评分<24 分。采用多变量 logistic 或线性回归分析评估 oxLDL 与认知障碍之间的关系。还研究了其他相关的临床变量。
本研究共纳入 3726 例患者[1287 例(34.54%)为女性],平均年龄为 63.62±11.96 岁。在我们的 logistic 回归模型中调整了潜在的混杂因素后,oxLDL 每增加一个标准差,认知障碍的患病率就会增加 26%(优势比,1.26;95%置信区间,1.13-1.39;P<0.0001)。同样,较高的 oxLDL 与较低的 MMSE 评分相关,在线性回归分析中,oxLDL 每增加一个标准差,MMSE 评分就会降低 0.56 分(β=-0.56;95%置信区间,-0.81 至-0.32;P<0.0001)。在认知障碍方面,oxLDL 与年龄、性别或教育程度之间没有显著的交互作用(所有交互作用,P>0.05)。
缺血性脑卒中患者 oxLDL 水平升高与认知障碍的患病率升高有关。