| Objectives:To explore the relationship between the serum IGF-1, Aβ1-42, VILIP-1concentration and cognitive impairment and the predicting value of the serum IGF-1, Aβ-42, VILIP-1concentration on cognitive impairment in patients with ischemic stroke, to evaluate the the role of some potential risk factors for cognitive impairment in these patients.Methods:124cases with acute ischemic stroke were admmitted in stroke unit ward of the Tianjin Huanhu Hospital with acute cerebral infarction were collected during June1,2012to December31,2012.96healthy volunteers were recruited as the healthy control, clinical information and dates were collected and analyzed. Fasting blood specimens were collected on the early morning at the first day of hospitalization. The concentrations of serum IGF-1, A β1-42, VILIP-1were quantitatively determinated by ELISA. The control group was followed up in3month after stroke and accessed cognitive impairment with MoCA. All the patients with ischemic stroke were followed up in3month after the onset of the stroke, tested with the HAMD,NIHSS,HIS,MoCA.124cases of cerebral infarction patients were divided into Cognitive impairment group and Normal cognition group by MoCA results. Compared respectively of the differences of serum IGF-1, A β1-42, VILIP-1concentration,baseline clinical information between the cerebral infarction group and control group, the cognitive impairment group and normal cognitive function group, and to explore the predictive value of cognitive impairment after ischemic stroke of serum IGF-1, A β1-42, VILIP-1concentration. The impact of major risk factors for cognitive impairment in patients with ischemic stroke was analyzed by logistic regression model.Results:1. There is no statistically significant differences in baseline clinical indicator between124cases of cerebral infarction patients and96cases of healthy volunteers (P>0.05).2. Compared with healthy volunteers, the cerebral infarction patients had significantly lower1GF-1concentration ([107.16±18.03] ng/ml vs [122.79±15.55] ng/ml; P<0.001), lower Aβ1-42concentration ([169.08±34.62] pg/ml vs [205.84±30.94] pg/ml; P<0.001), higher VILIP-1concentration ([571.73±151.69] pg/ml vs [491.18±116.30] pg/ml; P<0.001).3.124patients with cerebral infarction, according to the MoCA scale were divided into51cases of cognitive impairment group and73cases of normal cognitive function group, the incidence rate of cognitive impairment in patients with ischemic stroke was41.13%. Compared with normal cognitive function group,the cognitive impairment patients had lower total score of MoCA, visual spatial executive function, attention, language, abstraction and delayed memory,(P<0.001). The two groups showed no significant difference in the naming and orientation (P>0.05).4.Compared with normal cognitive function group, the cognitive impairment patients had significantly lower IGF-1concentration ([96.50±17.88] ng/ml vs [114.62±14.01] ng/ml; P<0.001), lower Aβ1-42concentration ([142.12±29.01] pg/ml vs [187.91±24.27] pg/ml; P<0.001), higher VILIP-1concentration ([669.69±103.84] pg/ml vs [503.29±142.39] pg/ml; P<0.001).5.Multivariate analysis results showed that:lower serum IGF-1concentration (OR=1.309, P=0.002), lower serum A p1-42concentration(OR=0.827, P<0.001), higher serum VILIP-1concentration(OR=1.013, P=0.008), hypertension (OR=41.469, P=0.006), diabetes mellitus (OR=24.730, P=0.008) and lower educational level (OR=0.71, P=0.036) were independent risk factors of cognitive impairment in patients with ischemic stroke.6. The concentration of IGF-1≤106.95ng/ml can predict the occurrence of cognitive impairment in patients ischemic stroke, the accuracy rate was74.2%; The serum A (31-42concentration≤166.09pg/ml can predict the occurrence of cognitive impairment in patients with ischemic stroke, the accuracy rate was83.9%;The concentration of serum VILIP-1≥586.90pg/ml can predict the occurrence of cognitive impairment in patients with ischemic stroke, the accuracy was87.1%; Combination of the three biomarkers to predict the accuracy of cognitive impairment in patients with ischemic stroke, the accuracy rate was89.5%.Conelusions:1. Lower serum IGF-1concentration or lower serum A β1-42concentration or higher serum VILIP-1concentration were independent risk factors for cognitive impairment in patients with ischemic stroke.2. Serum concentration of IGF-1≤106.95ng/ml or serum A β1-42concentration≤166.09pg/ml or serum VILIP-1concentration≥586.90pg/ml were predictive factors for cognitive impairment in patients with ischemic stroke incidence.3. The pretective value of the three biomarkers is prior to the single.4. Higher blood pressure, diabetes mellitus or lower educational level were independent risk factors for cognitive impairment after ischemic stroke. |
PDF Full Text Request