Study On The Correlation Between Metabolic Syndrome And Cognitive Dysfunction After Ischemic Stroke

Objective:To explore the correlation between Metabolic syndrome(MS)and cognitive impairment(VCI)after ischemic stroke.Analysis the incidence of ischemic stroke in patients with metabolic syndrome,clinical characteristics,evaluation of metabolic syndrome in patients with ischemic stroke after cognitive function,probes into the emergence of cognitive dysfunction in patients with ischemic stroke and the relationship of metabolic syndrome and its components,and the influence on vascular cognitive dysfunction,and to provide a basis for the prevention and treatment of poststroke cognitive disorder.Methods:This study were retrospectively analyzed the clinical data of 255 patients with ischenic stroke.The 67 patients with metabolic syndrome were classified as the research group,and the 158 patients without metabolic syndrome as the control group.We collected into index of blood sugar,HbAlc,HDL-C,LDL-C,A?,Blood pressure WHR and HOMA-IR of patients in two groups.To apply unified MOCA to every patient to check their cognitive function before they discharge from hospital.SPSS20.0 statistical software was used for data processing,The measurement data were expressed as mean plus or minus standard deviation(X±s),T test was used for comparison,The count data was expressed as a percentage,and the comparison was performed using the ?2 test.The relationship between components of metabolic syndrome and MoCA scores was analyzed by Pearson correlation.Univariate and multivariate Logistic regression analysis examined risk factors for secondary VCI after ischemic stroke.Results:1.There was no statistically significant difference between the two groups in age,gender,education time,the area of cerebral infarction,and neurological deficit score(P>0.05).2.Physical and chemical indicators and complications were compared between the two groups before admission:The index of Ap,FBG,HOMA IR,HbAlc,TG,LDL-C and Blood pressuer in research group were significantly higher than the control group,HDL-C were significantly lower than the control group,the difference is statistically significant(P<0.05);The TC value of MS group was slightly higher than that of non-ms group,and the difference was not statistically significant(P>0.05);The incidence of T2DM,hypertension,hyperlipidemia and multiple lesions was higher than that in the control group(P<0.05).3.Cognitive function comparison in 21 days in the two groups:The MoCA scores and visual space,executive ability,abstract thinking,memory and directional force scores of patients in research group were significantly lower than control group before then discharged from hospital(P<0.05),the incidence of cognitive impairment is higher than the control group(P<0.05).In MS patients,vascular cognitive dysfunction was 51.7%,and in N-MS patients,vascular cognitive dysfunction accounted for 30.1%.The prevalence of MS was significantly correlated with vascular cognitive dysfunction(P<0.05).4.Comparison of clinical data between VCI group and N-VCI group:The two groups showed no significant difference in gender,age,education level and other general clinical data(P>0.05).In the VCI group,A? and WHR significantly increased compared with the N-VCI group(P<0.001),SBP,FBG,HOMA-IR and TG were significantly increased(P<0.05),HDL-C is significantly lower(P<0.05).There was no significant difference in DBP,LDL-C and TC between the two groups(P>0.05).5.Correlation analysis between group scores and MoCA scores showed,with the increase of MS components,MoCA score gradually decreased,and 5 MS points reached the lowest value;the incidence of VCI was gradually increased,and the 5 metabolic groups reached the highest point in time(P<0.05).6.Pearson correlation analysis was performed for the MoCA score and MS components,the results showed that MoCA scores were negatively correlated with WHR,FBG,HOMA-IR and SBP(P<0.05),positively correlated with HDL-C(P<0.05);and had no correlation with TG and DBP(P>0.05).7.Take VCI as the dependent variable,the independent variables were sex,age,blood pressure,blood sugar,abdominal obesity,TG,HDL-C,and MS,and then grade it,univariate Logistic regression analysis was performed,The results show:The risk of VCI was 1.36,1.68 and 2.07 times for every 10 years of growth based on age<60;Men had a 1.84-fold increased risk of developing VCI compared to women;Elevated FBG,abdominal obesity,high blood pressure and decreased HDL-C can all increase the risk of VCI(OR values were 2.25,2.04,1.58 and 1.51 respectively);compared with N-MS patients,MS patients had a 2.59 times higher risk of developing VCI;with the increase of MS components,the risk of VCI was significantly increased.Compared with patients with one type of MS components,patients with five types of MS components had a 3.71-fold increased risk of VCI;at the same time,after adjusting for age and gender,abdominal obesity,high blood pressure and fasting blood glucose were correlated with the occurrence of secondary VCI in ischemic stroke.Conclusion:The incidence and degree of cognitive impairment after ischemic stroke in MS were significantly higher than that in patients without combined MS,and the combine-d MS was an independent predictor of secondary VCI in ischemic stroke.The secondary cognitive dysfunction of patients with ischemic stroke was mainly involved in visual space and executive ability,abstract thinking,memory and orientation.There was a significant correlation between MS components and vascular cognitive impairment secondary to ischemic stroke,and this correlation increased with the increase of the number of MS components.The incidence of secondary vascular cognitive impairment after ischemic stroke was correlated with abdominal obesity,high blood pressure and fasting blood glucose.Therefore,we should pay attention to the patients with ischemic stroke combine MS,early intervention on MS components can reduce the occurrence of cognitive impairment after ischemic stroke.