Potential Biomarkers of Post-stroke Cognitive Impairment in Chinese Population: a Systematic Review and Meta-Analysis

It is still controversial whether peripheral blood biomarkers have the potential to be diagnostic, prognostic, and therapeutic targets for post-stroke cognitive impairment (PSCI). All studies reporting the correlation between peripheral blood biomarkers and PSCI in Chinese acute ischemic stroke (AIS) patients were screened in eight databases and meta-analyses were performed to explore their predictive value for PSCI. The results showed that the levels of C-reactive protein (CRP), fasting blood glucose (FBG), homocysteine (Hcy), and cystatin C (CysC) were significantly higher in the PSCI group than in the post-stroke cognitive impairment no dementia (PSNCI) group. However, the differences in glycosylated hemoglobin (HbA1c), creatinine (Cr), blood urea nitrogen (BUN), and uric acid (UA) levels were not significant. The correlation between Hcy and PSCI applies to all AIS patients, whereas the correlation between CRP (p < 0.001), FBG (p = 0.005), CysC (p = 0.005), and PSCI is generalizable only to first-onset AIS. CRP may be a biomarker of cognitive impairment 3-6 months after AIS (3 months: p < 0.001; 6 months: p = 0.030) and does not appear to have a correlation in the long term. However, the correlation between FBG and PSCI may be significant 6 months to 1 year after AIS (6 months: p = 0.032; 1 year: p = 0.004), whereas the correlation between Hcy and PSCI may be significant 3 months to 1 year after AIS (3 months: p = 0.002; 6 months: p = 0.004; 1 year: p = 0.004). CRP, FBG, Hcy, and CysC may be potential biomarkers for PSCI, whereas the correlation between Cr, BUN, UA, and PSCI has not been confirmed.