Association Between Improvement Of Early Cognitive Function And CAPN10 Gene Polymorphism In Patients After Post-stroke

Objective.To investigate the clinical factors associated with early cognitive impairment improvement after post-stroke and the correlation between CAPN10 gene polymorphisms and the degree of cognitive impairment improvement after post-stroke.Methods.Patients with post-stroke who were hospitalized in the rehabilitation department of Subei People’s hospital from October 2020 to October 2022 were selected,according to inclusion and exclusion criteria,a total of 121 patients with post-stroke cognitive impairment were finally included.General clinical data,routine laboratory tests on admission,cognitive function scores and imaging data were collected.Patients were divided into two groups according to the degree of improvement of cognitive function after conventional medication and cognitive function training,with group A being the poorly improved group and group B being the better improved group.The differences in general data,laboratory parameters and CAPN10 gene polymorphism between the two groups were analyzed by SPSS26.0 statistical software,as well as the correlation between CAPN10 gene polymorphism and the improvement of cognitive impairment after post-stroke.Logistic regression analysis was used to screen for independent risk factors and the predictive value was assessed using subject work characteristic curves.Results.1.Comparing the general clinical data,the differences between the two groups were not statistically significant(P>0.05)in terms of age,BMI,gender,infarct site,number of infarct foci,and hypertension.However,the difference in the presence or absence of previous diabetes(X~2=6.667,P=0.002)was statistically significant between the two groups.2.The differences in red blood cell count,neutrophil percentage,platelet count,triglycerides,HDL cholesterol,LDL cholesterol,total cholesterol,and urea were not statistically significant(P>0.05).However,we found that patients in group A had significantly higher uric acid,hemoglobin content,white blood cell count,fasting glucose and creatinine than patients in group B.The differences in uric acid(Z=-2.633,P=0.043),hemoglobin content(Z=-3.497,P<0.001),white blood cell count(Z=-3.787,P<0.001),fasting glucose(Z=-2.196,P=0.028),and creatinine(Z=-2.056,P=0.040)were statistically significant between the two groups.3.According to the results of CAPN10 genotype testing,the frequency of GG pure heterozygotes at the rs3792267 locus of CAPN10 gene was 63.33%.In group A,there were 23 cases(76.67%)of GG genotype and 7 cases(23.33%)of AG+AA genotype;in group B,there were 15 cases(50.00%)of GG genotype and 15 cases(50.00%)of AG+AA genotype.The difference in genotype distribution between group A and group B was statistically significant(P=0.044).The frequency of CC pure heterozygotes at the rs5030952 locus of the CAPN10 gene was 56.67%.In group A:19cases(63.33%)of CC genotype and 11 cases(36.67%)of CT+TT genotype;group B:16 cases(53.33%)of CC genotype and 14 cases(46.67%)of CT+TT genotype.The difference in genotype distribution between group A and group B was not statistically significant(P>0.05).4.Multivariate logistic regression analysis showed that leukocyte count(P=0.003)and GG genotype at rs3792267 locus of CAPN10 gene(P=0.045)may be risk factors for low improvement in cognitive function after post-stroke.5.The independent risk factors showed that leukocyte count alone was more valuable in predicting the level of improvement of cognitive impairment after stroke(0.7<AUC<0.9),while the CAPN10 gene rs3792267 polymorphism alone was less valuable in predicting the level of improvement of cognitive impairment after post-stroke(0.5<AUC<0.7),and by combining the independent risk factors significantly improved the predictive value of the level of improvement of cognitive impairment after post-stroke(AUC=0.820).The predictive value of post-stroke cognitive impairment was significantly improved by combining independent risk factors(AUC=0.820).Conclusions.1.In patients with post-stroke with cognitive impairment,the degree of improvement in cognitive function after comprehensive rehabilitation is associated with history of diabetes,uric acid,creatinine,hemoglobin content,white blood cell count,and fasting blood glucose.2.The CAPN10 rs3792267 polymorphism was associated with improved cognitive function in patients with post-stroke with cognitive impairment,with a higher risk of low cognitive improvement after post-stroke in the GG genotype group.3.Increase in white blood cell count and CAPN10 gene rs3792267 polymorphism independently had value in predicting the degree of cognitive impairment improvement after post-stroke,and the predictive value of the degree of cognitive impairment improvement after post-stroke was improved by combining two independent factors.