Department of Geriatrics, Tangdu Hospital, Air Force Medical University, Xi'an, China.
Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi'an, China.
BMC Neurol. 2024 Feb 20;24(1):72. doi: 10.1186/s12883-024-03574-7.
Our research aims to elucidate the significance of type 2 diabetes (T2D) and provides an insight into a novel risk model for post-cerebral infarction cognitive dysfunction (PCICD).
Our study recruited inpatients hospitalized with cerebral infarction in Xijing hospital, who underwent cognitive assessment of Mini-Mental State Examination (MMSE) from January 2010 to December 2021. Cognitive status was dichotomized into normal cognition and cognitive impairment. Collected data referred to Demographic Features, Clinical Diseases, scale tests, fluid biomarkers involving inflammation, coagulation function, hepatorenal function, lipid and glycemic management.
In our pooled dataset from 924 eligible patients, we included 353 in the final analysis (age range 65-91; 30.31% female). Multivariate logistic regression analysis was performed to show that Rural Areas (OR = 1.976, 95%CI = 1.111-3.515, P = 0.020), T2D (OR = 2.125, 95%CI = 1.267-3.563, P = 0.004), Direct Bilirubin (OR = 0.388, 95%CI = 0.196-0.769, P = 0.007), Severity of Dependence in terms of Barthel Index (OR = 1.708, 95%CI = 1.193-2.445, P = 0.003) that were independently associated with PCICD, constituting a model with optimal predictive efficiency.
To the best of our knowledge, this study provides a practicable map of strategical predictors to robustly identify cognitive dysfunction at risk of post-cerebral infarction for clinicians in a broad sense. Of note, our findings support that the decline in serum direct bilirubin (DBil) concentration is linked to protecting cognitive function.
本研究旨在阐明 2 型糖尿病（T2D）的意义，并提供一种新的脑梗死后认知功能障碍（PCICD）风险模型的见解。
本研究纳入了 2010 年 1 月至 2021 年 12 月在西京医院住院的脑梗死患者，通过简易精神状态检查（MMSE）对其进行认知评估。认知状态分为正常认知和认知障碍。收集的数据包括人口统计学特征、临床疾病、量表测试、涉及炎症、凝血功能、肝肾功能、血脂和血糖管理的液体生物标志物。
在我们的 924 名合格患者的汇总数据集中，我们纳入了 353 名最终分析患者（年龄 65-91 岁，女性占 30.31%）。进行多变量逻辑回归分析显示，农村地区（OR=1.976，95%CI=1.111-3.515，P=0.020）、T2D（OR=2.125，95%CI=1.267-3.563，P=0.004）、直接胆红素（OR=0.388，95%CI=0.196-0.769，P=0.007）、Barthel 指数依赖程度（OR=1.708，95%CI=1.193-2.445，P=0.003）与 PCICD 独立相关，构成了一个具有最佳预测效率的模型。
据我们所知，本研究为临床医生提供了一个实用的策略性预测因子图谱，以稳健地识别脑梗死后认知功能障碍的风险。值得注意的是，我们的发现支持血清直接胆红素（DBil）浓度下降与保护认知功能有关。
