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Association between serum non-high-density lipoprotein cholesterol and cognitive impairment in patients with acute
Da Lu1, Pan Li1, Yuying Zhou2
1Department of Neurology, Sixteenth wards, Tianjin Huanhu Hospital, Tianjin, 300060, China.
Insights
High non-high density lipoprotein cholesterol (non-HDL-C) is linked to cognitive impairment after ischemic stroke. Elevated non-HDL-C levels independently predict cognitive disorders, highlighting its clinical importance for stroke patients.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Biochemistry
Background:
- Non-high density lipoprotein cholesterol (non-HDL-C) is a potential biomarker for vascular disease.
- Investigating the association between non-HDL-C and cognitive impairment post-acute ischemic stroke is crucial.
Purpose of the Study:
- To evaluate the relationship between serum non-HDL-C levels and cognitive impairment in patients following an acute ischemic stroke.
Main Methods:
- 725 patients with acute ischemic stroke were assessed for cognitive function using MMSE, MoCA, ADL, NPI, and HAMD-21.
- Lipid profiles, biochemical markers, and non-HDL-C levels were measured.
Main Results:
- Patients with high non-HDL-C exhibited significantly lower MMSE and MoCA scores and higher NPI and HAMD-21 scores.
- Elevated non-HDL-C correlated with poorer cognitive function and was an independent risk factor for cognitive disorders (OR=3.115).
- Higher levels of homocysteine, fasting blood glucose, and HbA1c were also observed in patients with high non-HDL-C.
Conclusions:
- High serum non-HDL-C is an independent risk factor for cognitive impairment after acute ischemic stroke.
- Age, education, homocysteine, and HAMD scores also contribute to cognitive impairment risk.
- Non-HDL-C is an easily assessable clinical parameter that indicates increased risk of cognitive disorders post-stroke.
Background:
Non-high density lipoprotein cholesterol (HDL-C) could be a good predictor of vascular disease outcomes. To evaluate the association between serum non-HDL-C and cognitive impairment in patients with acute ischemic stroke.
Methods:
A total of 725 hospitalized patients with acute ischemic stroke were enrolled. They received conventional treatment. Cognitive function was assessed on the 3rd day after admission using mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Activity of Daily Living Scale (ADL), and Neuropsychiatric Inventory (NPI, and Hamilton depression rating scale 21-item (HAMD-21). Lipid profile and biochemical markers were measured, and non-HDL-C was calculated.
Results:
Compared with patients with normal non-HDL-C, those with high non-HDL-C showed lower MMSE (23.1 ± 4.9 vs. 26.0 ± 4.6, P < 0.001) and MoCA (20.4 ± 6.4 vs. 22.2 ± 5.3 P = 0.01) scores, higher NPI (6.2 ± 1.2 vs. 3.3 ± 1.5, P < 0.001) and HADM-21 (6.0 ± 2.2 vs. 4.5 ± 1.9, P < 0.001) scores, and higher homocysteine (16.0 ± 3.8 vs. 14.3 ± 2.0 mmol/L, P = 0.044), fasting blood glucose (6.4 ± 2.7 vs. 6.1 ± 2.1 mmol/L, P = 0.041), and HbA1c (6.80 ± 1.32 % vs. 6.52 ± 1.17 %, P = 0.013) levels. MMSE (r = -0.526, P < 0.001), MoCA (r = -0.216, P < 0.001), and NPI (r = 0.403, P < 0.001) scores were correlated with non-HDL-C levels. High non-HDL-C levels were an independent risk factor for cognitive disorders after acute ischemic stroke (P = 0.034, odds ratio = 3.115, 95 % confidence interval: 1.088-8.917).
Conclusions:
High serum non-HDL-C levels, age, education, homocysteine levels, and HAMD score were independent risk factors of cognitive impairment in patients with acute ischemic stroke. The risk of cognitive disorders after acute ischemic stroke increased with increasing non-HDL-C levels. This parameter is easy to assess in the clinical setting.
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