Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu 215123, China.
Department of Orthopaedics, The Affiliated Suzhou Science and Technology Town Hospital, Nanjing Medical University, Suzhou, China.
J Affect Disord. 2022 Feb 15;299:287-293. doi: 10.1016/j.jad.2021.12.011. Epub 2021 Dec 11.
Previous researches have suggested that soluble triggering receptor expressed on myeloid cells 2 (sTREM2) plays a pivotal role in central nervous system pathologies and the development of neurodegenerative disorders. This study aimed to prospectively investigate the association between plasma sTREM2 levels and post-stroke cognitive impairment (PSCI).
A sample of 599 consecutive acute ischemic stroke patients with sTREM2 measurements from the China Antihypertensive Trial in Acute Ischemic Stroke were eventually included in this analysis. Cognitive impairment was defined as a score of <25 for Mini-Mental State Examination, measured at 3-month follow up. Binary logistic regression was used to estimate the odds ratios (ORs) of plasma sTREM2 levels on the risk of PSCI.
Of the 599 participants (mean age, 60.0 ± 10.4 years; male, 70.5%), 228 (38.1%) patients were diagnosed as PSCI. The risk of PSCI elevated significantly with higher plasma sTREM2 levels (p for trend <0.01). After adjusting for several confounding factors, the ORs for the highest quartile of sTREM2 compared with the lowest quartile was 2.06 (95% confidence interval, 1.20-3.53) for PSCI. Moreover, the addition of sTREM2 to the conventional model with established risk factors significantly improved risk discrimination (C-statistics increased from 0.668 to 0.691, p = 0.02) and reclassification (net reclassification improvement: 32.2%, p < 0.001; integrated discrimination improvement: 1.3%, p = 0.01) for PSCI.
Results might be subject to selective bias and potential confounding.
The present study demonstrated that elevated level of plasma sTREM2 may be associated with PSCI, and sTREM2 has potential value in predicting PSCI.
先前的研究表明，髓样细胞触发受体 2 可溶性（sTREM2）在中枢神经系统疾病和神经退行性疾病的发展中发挥着关键作用。本研究旨在前瞻性研究血浆 sTREM2 水平与卒中后认知障碍（PSCI）的相关性。
从中国急性缺血性卒中降压试验（CATIS）中纳入了 599 例连续急性缺血性卒中患者，对其进行 sTREM2 测量，最终将其中 599 例患者纳入本分析。认知障碍定义为 3 个月随访时简易精神状态检查（MMSE）评分＜25 分。采用二元 logistic 回归估计血浆 sTREM2 水平对 PSCI 风险的比值比（OR）。
599 例患者（平均年龄 60.0±10.4 岁，男性占 70.5%）中，228 例（38.1%）患者诊断为 PSCI。随着血浆 sTREM2 水平升高，PSCI 的风险显著升高（趋势检验 p＜0.01）。调整了几个混杂因素后，sTREM2 最高四分位数与最低四分位数相比，PSCI 的 OR 为 2.06（95%置信区间 1.20~3.53）。此外，将 sTREM2 加入到具有既定危险因素的常规模型中，显著提高了风险区分度（C 统计量从 0.668 增加到 0.691，p=0.02）和重新分类（净重新分类改善：32.2%，p＜0.001；综合鉴别改善：1.3%，p=0.01）。
结果可能受到选择性偏倚和潜在混杂因素的影响。
本研究表明，血浆 sTREM2 水平升高可能与 PSCI 相关，sTREM2 对预测 PSCI 具有潜在价值。
