| Objectives:With the aging of social population,more and more people in the middle-aged and elderly population suffer from acute ischemic stroke,and the proportion of people with cognitive impairment is also increasing.Cognitive impairment can gradually develop into dementia,so early identification of risk factors for cognitive impairment after acute ischemic stroke and intervention can prevent dementia.Existing research shows that the thyroid function status and type 2 diabetes mellitus(T2DM)are correlated with cognitive impairment after acute ischemic stroke.Thyroid dysfunction,whether hypothyroidism or hyperthyroidism,increases the risk of cognitive impairment.The subjects of this study were patients with T2DM complicated with acute ischemic stroke.The differences between the cognitive impairment group and the cognitive normal group were analyzed by grouping them on the Montreal Cognitive Assessment(MoCA)scale.The purpose is to reveal the relationship between thyroid function status and cognitive impairment after acute ischemic stroke in T2DM patients,and to explore whether thyroid-related hormone levels can predict the risk of cognitive impairment after acute ischemic stroke in T2DM patients.Methods:1.A total of 94 T2DM complicated with acute ischemic stroke were selected as research objects according to the inclusion criteria,.2.Age,gender,education level,smoking history,drinking history,systolic blood pressure,diastolic blood pressure,body mass index,previous medical history(hypertension,coronary atherosclerotic heart disease,history of cerebral infarction),number and location of infarction in imaging were collected.The levels of fasting venous serum thyroid-related hormones,blood lipids,fasting blood glucose and glycosylated hemoglobin in the patients were measured in the morning after admission.3.All subjects completed MoCA scales within 2 weeks of onset,and were divided into the cognitive impairment group(n=54)and cognitive normal group(n=40)according to the score results.4.The incidence of cognitive impairment in T2DM patients with acute ischemic stroke at 2 weeks of onset was calculated.The differences of thyroid-related hormones,biochemical indicators and general information were compared between the two groups,and the independent risk factors of cognitive impairment after acute ischemic stroke were analyzed with multivariate binary Logistic regression analysisResults:1.Incidence of cognitive impairment:a total of 94 T2DM complicated with acute ischemic stroke were selected in this study,among whom 54 had cognitive impairment and the incidence of cognitive impairment was 57.45%.2.Comparison of clinical data between the two groups:the proportion of previous acute ischemic stroke history in the two groups was statistically significant(P<0.05),and the proportion of previous acute ischemic stroke history in the cognitive impairment group was higher than that in the cognitive normal group.There were no statistical differences in age,gender,education level,smoking,drinking,history of hypertension,history of coronary atherosclerotic heart disease,body mass index,systolic blood pressure,diastolic blood pressure,number and location of cerebral infarction between the two groups(P>0.05).3.Comparison of serum thyroid-related hormone levels between the two groups:the cognitive impairment group had higher level of thyroxine stimulating hormone(TSH)(P<0.001),lower level of free triiodothyronine(FT3)(P<0.01)than the cognitive normal group.4.Comparison of blood biochemical indicators between the two groups:the level of glycosylated hemoglobin in the cognitive impairment group was higher than that in the cognitive normal group(P<0.05),and there were no statistical differences in fasting plasma glucose and blood lipids between the two groups(P>0.05).5.Logistic regression analysis:after age,sex,education level,previous acute ischemic stroke history,basic diseases,living habits,fasting plasma glucose and blood lipid were adjusted,Logistic regression analysis showed that TSH might be an independent risk factor of cognitive impairment after acute ischemic stroke in T2DM patients,while FT3 might be a protective factorConclusions:1.The incidence of cognitive impairment after acute ischemic stroke in T2DM patients is high.2.Univariate analysis showed that the cognitive impairment group had higher level of thyroxine stimulating hormone(TSH),lower level of free triiodothyronine(FT3),higher incidence of cerebral infarction and higher level of glycosylated hemoglobin than the cognitive normal group.There were no statistical differences in age,sex,education level,living habits(smoking,drinking),basic diseases(hypertension,coronary heart disease),body mass index,systolic blood pressure,diastolic blood pressure,number of cerebral infarction foci,location of infarction,fasting plasma glucose,blood lipids and free thyroxine(FT4)between the two groups3.Multi variate binary Logistic regression analysis showed that in T2DM patients with acute ischemic stroke,TSH may be an independent risk factor for cognitive impairment,while FT3 may be a protective factor.4.Multivariate binary Logistic regression analysis has not found the correlation between fasting plasma glucose,glycosylated hemoglobin and cognitive level of T2DM patients after acute ischemic stroke. |
PDF Full Text Request