Correlation Of Stress Hyperglycemia After Ischemic Stroke And Early Cognitive Impairment

Objective:To investigate the relationship between stress hyperglycemia and cognitive impairment.Methods:This study included 422 cases of acute non-diabetic stroke patients.The patients were divided into three groups according to the fasting plasma glucose level.They were the euglycemia group(<6.1mmol/L),the mild stress hyperglycemia group(6.1mmol/L?7.0mmol/L)and the severe stress hyperglycemia group(?7.0mmol/L).Mini-Mental State Examination(MMSE),Alzheimer's Disease Rating Scale cognitive subscale(ADAS-cog),Clinical Dementia Rating scale(CDR)were used to evaluate early cognition in post-stroke patients.Patients were divided into three groups:normal cognitive function,vascular mild cognitive impairment and vascular dementia according to the cognitive diagnosis standards.Correlation analysis was carried out on the two kinds of classification variables.Statistical analysis was performed with the statistical package SPSS 21.0 Significance is defined as a two tailed P<0.05.Results:In all patients,there were 62 cases with stress hyperglycemia,the incidence was 14.69%.The stress hyperglycemia occurs most often in non-diabetic stroke patients with a high degree of education or a history of cardiovascular disease.Finally,270 cases of vascular cognitive impairment(VCI)were screened out,the incidence was 64.0%.Age,sex,smoking,NIHSS score,HAMD scores,stress hyperglycemia and history of cardiovascular disease were related with early VCI after non-diabetic ischemic stroke(P<0.05).Multivariate Logistic regression analysis showed that,stress hyperglycemia was the independent risk factor for VCI in patients with non-diabetic ischemic stroke(OR=3.086,95%CI:1.065?8.929).The risks of cognitive impairment in the mild stress hyperglycemia group and the severe stress hyperglycemia group were higher than that of the euglycemia group,while it was also higher in the severe stress hyperglycemia group than in the mild stress hyperglycemia group.Stress hyperglycemia was positively correlated with the high risk of early cognitive impairment in stroke patients(rs=0.185,P=0.007).Conclusions:Acute non-diabetic stroke patients with a high degree of education or a history of cardiovascular disease were at increased risk of stress hyperglycemia.Age,sex,smoking,NIHSS score,HAMD scores,stress hyperglycemia and history of cardiovascular disease were related with early cognitive impairment after non-diabetic ischemic stroke.Stress hyperglycemia was the independent risk factor for early cognitive impairment in patients with non-diabetic ischemic stroke,indicating that early detecting and better control of stress hyperglycemia may have beneficial effect on the outcome of vascular cognitive impairment.