Department of Neurology, Weifang People's Hospital, Weifang, Shandong, China.
Operating Room, Weifang Brain Hospital, Weifang, Shandong, China.
Braz J Med Biol Res. 2020 Oct 30;53(12):e9487. doi: 10.1590/1414-431X20209487. eCollection 2020.
This study aimed to explore the association between serum non-high-density lipoprotein cholesterol (non-HDL-C) and cognitive dysfunction risk in patients with acute ischemic stroke (AIS). This cross-sectional study enrolled 583 AIS patients. Biochemical markers and lipid profile were collected after admission. AIS patients were classified into high group (non-HDL-C ≥3.4 mM) and normal group (non-HDL-C <3.4 mM). Mini-Mental State Examination scale (MMSE), Montreal Cognitive Assessment scale (MoCA), Activities of Daily Living (ADL) scale, Neuropsychiatric Inventory (NPI), and Hamilton Depression scale 21 version (HAMD-21) were applied on the third day after admission. Compared with the control group, patients of the high group had higher body mass index and higher frequency of intracranial artery stenosis, and exhibited higher levels of non-HDL-C, total cholesterol, triglycerides, low-density lipoprotein cholesterol, homocysteine, fasting blood glucose, and glycosylated hemoglobin (HbA1c), and lower levels of high-density lipoprotein cholesterol (all P<0.05). Compared with the control group, patients of the high group had significantly lower MMSE and MoCA scores (MMSE: 26.01±4.17 vs 23.12±4.73, P<0.001; MoCA: 22.28±5.28 vs 20.25±5.87, P<0.001) and higher scores on the NPI and HAMD-21 (both P<0.001). MMSE (r=-0.306, P<0.001) and MoCA scores (r=-0.251, P<0.001) were negatively associated with non-HDL-C level. Multivariate regression analysis revealed that non-HDL-C level (OR=1.361, 95%CI: 1.059-1.729, P=0.016) was independently associated with the presence of cognitive dysfunction after adjusting for confounding factors. High serum non-HDL-C level might significantly increase the risk of cognitive dysfunction after AIS.
本研究旨在探讨血清非高密度脂蛋白胆固醇（non-HDL-C）与急性缺血性脑卒中（AIS）患者认知功能障碍风险之间的关系。这项横断面研究纳入了 583 例 AIS 患者。患者入院后采集生化标志物和血脂谱数据。根据非-HDL-C 水平将 AIS 患者分为高组（non-HDL-C≥3.4mmol/L）和正常组（non-HDL-C<3.4mmol/L）。入院后第 3 天，采用简易精神状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）、日常生活活动量表（ADL）、神经精神问卷（NPI）和汉密尔顿抑郁量表 21 项版本（HAMD-21）对患者进行评估。与对照组相比，高组患者的体重指数更高，颅内动脉狭窄发生率更高，非-HDL-C、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、同型半胱氨酸、空腹血糖和糖化血红蛋白水平更高，高密度脂蛋白胆固醇水平更低（均 P<0.05）。与对照组相比，高组患者的 MMSE 和 MoCA 评分明显更低（MMSE：26.01±4.17 比 23.12±4.73，P<0.001；MoCA：22.28±5.28 比 20.25±5.87，P<0.001），NPI 和 HAMD-21 评分更高（均 P<0.001）。MMSE 评分（r=-0.306，P<0.001）和 MoCA 评分（r=-0.251，P<0.001）与非-HDL-C 水平呈负相关。多变量回归分析显示，在校正混杂因素后，非-HDL-C 水平（OR=1.361，95%CI：1.059-1.729，P=0.016）与认知功能障碍的发生独立相关。血清非-HDL-C 水平升高可能显著增加 AIS 后认知功能障碍的风险。
