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Plasma fibroblast growth factor 21 and risk of cognitive impairment among patients with ischemic stroke
Xiaowei Zheng1, Zhengbao Zhu2, Chongke Zhong2
1Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China; Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China.
Background And Aims:
Previous study reported that plasma fibroblast growth factor 21 (FGF-21) was associated with poor prognosis in patients with ischemic stroke. The purpose of present study was to prospectively investigate the relationship between plasma FGF-21 and post-stroke cognitive impairment (PSCI).
Methods:
A total of 600 patients from 7 hospitals were included in this study and plasma FGF-21 levels were examined for all the participants. Cognitive impairment was evaluated using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at 3 months after ischemic stroke onset.
Results:
323(53.8 %) or 419(69.8 %) participants had PSCI according to MMSE or MoCA at 3 months, respectively. After adjustment for age, National Institutes of Health stroke score, education, and other covariates, the odds ratio of PSCI defined by MMSE and MoCA for the highest vs lowest quartile of plasma FGF-21 was 1.77(1.05-2.98) and 2.40(1.35-4.29), respectively. Multiple-adjusted spline regression model showed a linear association between FGF-21 levels and PSCI (all P < 0.005 for linearity). Subgroup analyses further confirmed these results.
Conclusion:
Elevated plasma FGF-21 level was associated with PSCI at 3 months after stroke independently of established conventional risk factors, suggesting that plasma FGF-21 may have potential prognostic value in risk stratification of PSCI.
