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 Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China.
J Affect Disord. 2022 Nov 15;317:221-227. doi: 10.1016/j.jad.2022.08.052. Epub 2022 Aug 24.
Neuropeptide Y (NPY) has a modulatory role in learning and memory, and is involved in the pathophysiology of neurodegenerative diseases. However, there was no population-based evidence on the relationship between NPY and post-stroke cognitive impairment (PSCI). We aimed to prospectively examine the association between plasma NPY and cognitive impairment among patients with acute ischemic stroke.
On the basis of samples from the China Antihypertensive Trial in Acute Ischemic Stroke, 593 patients with baseline plasma NPY levels were finally included in this study. The study outcome was cognitive impairment (Montreal Cognitive Assessment score < 26) at 3 months after ischemic stroke. Logistic regression models were used to estimate the risk of cognitive impairment.
After 3 months of follow-up, 422 participants (71.2 %) experienced cognitive impairment. Multivariable-adjusted odds ratio (95 % confidence interval) for the highest tertile of NPY was 0.58 (0.36-0.92) compared with the lowest tertile. Each 1-SD higher log-NPY was associated with a decreased risk of 20 % (95 % confidence interval 2 %-34 %) for PSCI. The addition of plasma NPY to the basic model with conventional risk factors improved the risk reclassification (continuous net reclassification index was 22.8 %, p = 0.01; integrated discrimination improvement was 0.9 %, p = 0.02) for PSCI.
We measured plasma NPY only once at baseline and failed to explore the association between NPY changes and PSCI.
Elevated plasma NPY levels were associated with a decreased risk of cognitive impairment, suggesting plasma NPY may serve as a predictive factor and potential therapeutic target for PSCI.
神经肽 Y（NPY）在学习和记忆中具有调节作用，并且参与神经退行性疾病的病理生理学。然而，在人群中，没有关于 NPY 与卒中后认知障碍（PSCI）之间关系的证据。我们旨在前瞻性研究急性缺血性卒中患者血浆 NPY 与认知障碍之间的关系。
在中国降压试验急性缺血性卒中的样本基础上，最终纳入了 593 名基线血浆 NPY 水平的患者。研究结局为卒中后 3 个月的认知障碍（蒙特利尔认知评估评分<26）。采用 logistic 回归模型估计认知障碍的风险。
在 3 个月的随访后，422 名参与者（71.2%）出现认知障碍。与最低三分位相比，NPY 最高三分位的多变量校正比值比（95%置信区间）为 0.58（0.36-0.92）。每 1-SD 更高的 log-NPY 与 PSCI 风险降低 20%（95%置信区间 2%-34%）相关。将血浆 NPY 添加到具有常规危险因素的基本模型中，可提高风险再分类（连续净再分类指数为 22.8%，p=0.01；综合鉴别改善为 0.9%，p=0.02）。
我们仅在基线时测量了一次血浆 NPY，未能探讨 NPY 变化与 PSCI 之间的关系。
升高的血浆 NPY 水平与认知障碍风险降低相关，表明血浆 NPY 可能作为 PSCI 的预测因子和潜在治疗靶点。
