| Objective: To study the relationship between glucose metabolism disorders and cognitive functions in patients with small-artery occlusion stroke(SAO) in the acute phase and explore the risk factors for vascular cognitive impairment in these patients.Methods: Retrospectively, the SAO patients met the inclusion criteria were collected in Tianjin Huanhu Hospital during January 1, 2010 to December 31, 2013. Comprehensive collected the clinical informations of the objects. All of the patients were divided into three groups by cognitive screening tests: normal cognition(NC) group, MCI group and dementia group. NC group and MCI group were available as the first part objects. NC group and dementia group were available as the second part objects. Every part of the patients were divided into normal blood(NB) group, impaire glucose regulation(IGR) group and diabetic group by the result of glucose metabolism tests. We may analyze each part of the data by the following statistical method. Compared the differences of MMSE score and Mo CA score among NB groups, IGR group and diabetic group and understand the difference of cognitive function among the glucose metabolism groups. Secondly, their general clinical data, medical histories, neuropsychological scale score and biochemical indexes were analyzed. Then, the impact of independent risk factors for cognitive impairment in SAO patients was analyzed by logistic regression model.Results: Part 1: There were no statistical differences in MMSE score among NB groups, IGR group and diabetic group(P>0.05). Significant difference could be noted in Mo CA score(P=0.047). Mo CA score of NB group was significantly higher than that of IGR group(25.06 ± 1.77 vs 24.35 ± 1.86, P=0.015). Mo CA score of IGR group was significant lower than that of diabetic group(24.35 ± 1.86 vs 24.99 ± 1.90, P=0.031). Mo CA score of NB group was higer than that of diabetic group, but no significant difference was noted(P>0.05). Compared with MCI group, the NC group patients had significantly lower incidence of hypertension(68.71 vs 81.01, P=0.021),lower incidence of Hycy(24.39 vs 41.77, P=0.001) and lower the rate of patients with sedentary lifestyle(14.08 vs 25.32, P=0.006). There were significant different in education levels between NC group and MCI group(P=0.047). No significant difference was noted in other risk factors between two groups(P>0.05). Logistic regression analysis showed that the incidence of MCI was 1.9-fold higher in hypertensive patients than in non-hypertensive patients(95%CI 1.094~3.462, P=0.024), was 2.4-fold higher in Hhcy patients than in non-Hhcy patients(95%CI 1.481~3.788, P<0.001) and was 2.2-fold higher in patients with sedentary lifestyle than in those without sedentary lifestyle(95%CI 1.311~3.841, P=0.003). Part2: Significant difference could be noted in MMSE score among NB groups, IGR group and diabetic group(P=0.008). MMSE score of NB group was significantly higher than that of diabetic group(28.31 ± 3.79 vs 27.49 ± 6.79, P=0.042). There were no statistical differences in MMSE score between NB groups and IGR group and no significant difference of that was noted between IGR group and diabetic group(P>0.05). Significant difference could be noted in Mo CA score among NB groups, IGR group and diabetic group(P<0.001). Mo CA score of NB group was significantly higher than that of diabetic group(24.29 ± 3.18 vs 23.02 ± 7.38, P=0.001). Mo CA score of IGR group was significant higer than that of diabetic group(24.18 ± 1.66 vs 23.02 ± 7.38, P=0.019). Mo CA score of NB group was higer than that of IGR group, but no significant difference was noted(P>0.05). Compared with dementia group, the NC group patients had significantly lower incidence of glucose metabolism disorders(67.74 vs 58.14, 2.58 vs 3.26, 29.68 vs 38.60, P=0.021). The significant difference was noted in age(41.18 vs 54.88, P<0.001) and gender(70.94 vs 60.00, P=0.001) between NC groups and dementia group. The incidence of hypertension(68.71 vs 78.14, P=0.006), Hycy(24.39 vs 54.42, P<0.001), family history of stroke(9.13 vs 17.21, P<0.001), obesity(8.71 vs 13.95, P=0.014) and the rate of patients with sedentary lifestyle(14.08 vs 23.26, P<0.001) were lower in normal cognition group than in dementia group. There were significant different in education levels between NC group and MCI group(P=0.002). No significant difference was noted in other ridk factors between these groups(P>0.05). Logistic regression analysis showed that the incidence of dementia was 1.3-fold higher in patients with glucose metabolism disorders than those without glucose metabolism disorders(95%CI 1.055~1.531, P=0.012), was 1.4-fold higher in olders(95%CI 1.056~1.984, P=0.022), was 1.8-fold higher in female than in male(95%CI 1.260~2.451, P=0.001), was1.6-fold higher in hypertensive patients than in non-hypertensive patients(95%CI 1.134~2.329, P=0.008), was 4.0-fold higher in Hhcy patients than in non-Hhcy patients(95%CI 2.890~5.503, P<0.001), was 1.8-fold higher in patients with family history of stroke than those without family history of stroke(95%CI 1.192~2.826, P=0.006) and was 2.2-fold higher in patients with sedentary lifestyle than in those without sedentary lifestyle(95%CI 1.501~3.250, P<0.001).Conclusion: 1. Glucose metabolism disorders may harmful for cognitive function. 2. Glucose metabolism disorders were not the independent risk factors for MCI. Hypertension, Hhcy and sedentary lifestyle are closely related with MCI in SAO patients and are thus the independent risk factors for MCI. 3. Glucose metabolism disorders, age, female, Hypertension, Hhcy, family history of stroke and sedentary lifestyle are independent risk factors for dementia. |
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