Wang Ziyi, Zhang Kaixin, Zhong Chongke, Zhu Zhengbao, Zheng Xiaowei, Yang Pinni, Che Bizhong, Lu Yaling, Zhang Yonghong, Xu Tian
Department of Neurology, Affiliated Hospital of Nantong University Medical School of Nantong University Nantong China.
Department of Clinical Research Center Wuxi No. 2 People's Hospital (Jiangnan University Medical Center) Wuxi China.
J Am Heart Assoc. 2025 Jan 21;14(2):e036790. doi: 10.1161/JAHA.124.036790. Epub 2025 Jan 17.
Our study aimed at evaluating the association between plasma human cartilage glycoprotein-39 (YKL-40) and cognitive impairment at 3 months among patients with acute ischemic stroke.
Plasma YKL-40 levels were measured in 604 participants from the China Antihypertensive Trial in Acute Ischemic Stroke. Cognitive impairment outcomes were assessed at 3 months poststroke using the Mini-Mental State Examination and the Montreal Cognitive Assessment. According to the Mini-Mental State Examination score, patients in the highest quartile of YKL-40 had a 2.01-fold (95% CI, 1.23-3.29; for trend=0.009) risk of poststroke cognitive impairment compared with those in the lowest quartile. Each 1 SD difference of logarithm-transformed YKL-40 was associated with a 28% (95% CI, 7-53) increased risk for the outcome. The multiple-adjusted spline regression model confirmed dose-response relationships between YKL-40 and poststroke cognitive impairment ( for linearity=0.01). Adding YKL-40 to a model containing conventional risk factors significantly improved the discriminatory power (area under the receiver operating characteristic curve improved by 0.02, =0.03). When cognitive impairment was defined using the Montreal Cognitive Assessment score, similar findings were observed.
Elevated YKL-40 levels were associated with an increased risk of cognitive impairment at 3 months among patients with acute ischemic stroke.
URL: clinicaltrials.gov; Unique Identifier: NCT01840072.
我们的研究旨在评估急性缺血性中风患者血浆中人类软骨糖蛋白-39（YKL-40）与3个月时认知障碍之间的关联。
在中国急性缺血性中风降压试验的604名参与者中测量了血浆YKL-40水平。在中风后3个月使用简易精神状态检查表和蒙特利尔认知评估对认知障碍结果进行评估。根据简易精神状态检查表评分，YKL-40处于最高四分位数的患者与处于最低四分位数的患者相比，中风后认知障碍风险高2.01倍（95%CI，1.23 - 3.29；趋势检验P = 0.009）。对数转换后的YKL-40每相差1个标准差，该结果的风险增加28%（95%CI，7 - 53）。多元调整样条回归模型证实了YKL-40与中风后认知障碍之间的剂量反应关系（线性检验P = 0.01）。将YKL-40添加到包含传统危险因素的模型中可显著提高鉴别能力（受试者工作特征曲线下面积提高0.02，P = 0.03）。当使用蒙特利尔认知评估评分定义认知障碍时，观察到类似结果。
急性缺血性中风患者中，YKL-40水平升高与3个月时认知障碍风险增加相关。
网址：clinicaltrials.gov；唯一标识符：NCT01840072。
