Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China.
J Cell Mol Med. 2020 Jul;24(13):7470-7478. doi: 10.1111/jcmm.15369. Epub 2020 May 20.
The expression of tissue inhibitor metalloproteinase-1 (TIMP-1) significantly increased after acute cerebral ischaemia and involved in neurodegeneration. The purpose was to prospectively investigate the relationship between serum TIMP-1 with post-stroke cognitive impairment. Our participants were from an ancillary study of China Antihypertensive Trial in Acute Ischemic Stroke. 598 ischaemic stroke patients from seven participating hospitals were included. Cognitive impairment was evaluated using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at 3 months. 316 (52.84%) or 384 (64.21%) participants had cognitive impairment according to MMSE or MoCA, respectively. Compared with the first quartile of TIMP-1, the multivariate-adjusted odds ratios (95% confidence intervals) for the highest quartile were 1.80 (1.09-2.97) for cognitive impairment defined by MMSE and 2.55 (1.49-4.35) by MoCA. Multiple-adjusted spline regression models showed linear associations between TIMP-1 concentrations and cognitive impairment (P value for linearity < 0.01). The addition of TIMP-1 to models including conventional factors improved reclassification for cognitive impairment, as shown by net reclassification index or integrated discrimination improvement (P < 0.05). Participants with both higher TIMP-1 and matrix metalloproteinase-9 levels simultaneously had highest risk of cognitive impairment. Higher serum TIMP-1 levels were associated with increased risk of cognitive impairment after acute ischaemic stroke, independently of established risk factors.
组织金属蛋白酶抑制剂-1（TIMP-1）的表达在急性脑缺血后显著增加，并参与神经退行性变。目的是前瞻性研究血清 TIMP-1 与卒中后认知障碍的关系。我们的参与者来自中国降压试验急性缺血性卒中的辅助研究。来自 7 家参与医院的 598 例缺血性卒中患者被纳入研究。使用简易精神状态检查（MMSE）和蒙特利尔认知评估（MoCA）在 3 个月时评估认知障碍。根据 MMSE 或 MoCA，分别有 316（52.84%）或 384（64.21%）名参与者存在认知障碍。与 TIMP-1 的第一四分位数相比，最高四分位数的多变量校正比值比（95%置信区间）分别为 MMSE 定义的认知障碍 1.80（1.09-2.97）和 MoCA 定义的认知障碍 2.55（1.49-4.35）。多变量调整的样条回归模型显示 TIMP-1 浓度与认知障碍之间存在线性关联（线性检验 P 值<0.01）。将 TIMP-1 添加到包括常规因素的模型中可以改善认知障碍的重新分类，表现为净重新分类指数或综合鉴别改善（P<0.05）。同时具有较高 TIMP-1 和基质金属蛋白酶-9 水平的参与者认知障碍风险最高。较高的血清 TIMP-1 水平与急性缺血性卒中后认知障碍风险增加独立于已确立的危险因素相关。
