高血浆多胺水平与中风后认知障碍风险增加相关：来自CATIS的一项多中心前瞻性研究
High Plasma Polyamine Levels Are Associated With an Increased Risk of Poststroke Cognitive Impairment: A Multicenter Prospective Study From CATIS.
作者信息
He Yu, Jia Yiming, Liu Yi, Chang Xinyue, Yang Pinni, Shi Mengyao, Guo Daoxia, Peng Yanbo, Chen Jing, Wang Aili, Xu Tan, He Jiang, Zhang Yonghong, Zhu Zhengbao
机构信息
Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Noncommunicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology Suzhou Medical College of Soochow University Suzhou, Jiangsu Province China.
Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA United States.
出版信息
J Am Heart Assoc. 2025 Jan 21;14(2):e037465. doi: 10.1161/JAHA.124.037465. Epub 2025 Jan 16.
BACKGROUND
Polyamines have been suggested to play pivotal roles in ischemic stroke and neurodegenerative disorders, but the associations of plasma polyamines with poststroke cognitive impairment (PSCI) remain unclear. We aimed to prospectively investigate the associations of plasma putrescine, spermidine, and spermine with PSCI among patients with ischemic stroke in a multicenter cohort study.
METHODS AND RESULTS
We measured plasma polyamine levels at baseline among 619 patients with ischemic stroke from a preplanned ancillary study of CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). We used the Mini-Mental State Examination and Montreal Cognitive Assessment to evaluate cognitive function at 3-month follow-up after ischemic stroke, and PSCI was defined as Mini-Mental State Examination score <27 or Montreal Cognitive Assessment score <25. According to the Mini-Mental State Examination score, plasma polyamines were positively associated with PSCI. The adjusted odds ratios of PSCI for the highest versus lowest quartile of putrescine, spermidine, and spermine were 1.81 (95% CI, 1.09-3.00), 1.81 (95% CI, 1.09-3.01), and 1.92 (95% CI, 1.15-3.20), respectively. In addition, plasma putrescine (net reclassification improvement, 32.08%; <0.001; integrated discrimination improvement, 1.62%; =0.002), spermidine (net reclassification improvement, 25.29%; =0.002; integrated discrimination improvement, 1.22%; =0.006), and spermine (net reclassification improvement, 16.54%; =0.045; integrated discrimination improvement, 1.36%; =0.004) could significantly improve the risk reclassification of PSCI beyond established risk factors. There were similar significant relationships when PSCI was defined by Montreal Cognitive Assessment score.
CONCLUSIONS
Higher plasma polyamine levels were associated with increased risk of PSCI among patients with ischemic stroke. Our findings suggest that plasma polyamines should be implicated in the pathophysiologic processes of PSCI and may be the potential intervention targets for PSCI.
REGISTRATION
URL: https://www.clinicaltrials.gov; Unique identifier: NCT01840072.
背景
多胺被认为在缺血性卒中和神经退行性疾病中起关键作用，但血浆多胺与卒中后认知障碍（PSCI）之间的关联仍不清楚。我们旨在通过一项多中心队列研究，前瞻性地调查缺血性卒中患者血浆腐胺、亚精胺和精胺与PSCI之间的关联。
方法与结果
我们在CATIS（中国急性缺血性卒中降压试验）的一项预先计划的辅助研究中，测量了619例缺血性卒中患者基线时的血浆多胺水平。我们在缺血性卒中后3个月随访时，使用简易精神状态检查表和蒙特利尔认知评估量表来评估认知功能，PSCI被定义为简易精神状态检查表评分<27或蒙特利尔认知评估量表评分<25。根据简易精神状态检查表评分，血浆多胺与PSCI呈正相关。腐胺、亚精胺和精胺最高四分位数与最低四分位数相比，PSCI的校正比值比分别为1.81（95%CI，1.09 - 3.00）、1.81（95%CI，1.09 - 3.01）和1.92（95%CI，1.15 - 3.20）。此外，血浆腐胺（净重新分类改善，32.08%；<0.001；综合判别改善，1.62%；=0.002）、亚精胺（净重新分类改善，25.29%；=0.002；综合判别改善，1.22%；=0.006）和精胺（净重新分类改善，16.54%；=0.045；综合判别改善，1.36%；=0.004）能够显著改善PSCI超出既定危险因素的风险重新分类。当用蒙特利尔认知评估量表评分定义PSCI时，也有类似的显著关系。
结论
缺血性卒中患者血浆多胺水平较高与PSCI风险增加相关。我们的研究结果表明，血浆多胺应参与PSCI的病理生理过程，可能是PSCI的潜在干预靶点。
注册信息
Zotero 插件