Association between Metabolic Syndrome and Cognitive Impairment after Acute Ischemic Stroke: A Cross-Sectional Study in a Chinese Population

PLoS One. 2016 Dec 9;11(12):e0167327. doi: 10.1371/journal.pone.0167327. eCollection 2016.

Abstract

Background and objectives: Metabolic syndrome (MetS), a risk factor for many vascular conditions, is associated with vascular cognitive disorders. The objective of the present study was to explore the associations of MetS and its individual components with the risks of cognitive impairment and neurological dysfunction in patients after acute stroke.

Methods: This cross-sectional study enrolled 840 patients ranging in age from 53 to 89 years from the Tianjin area of North China. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination. Neuropsychiatric behavior was assessed using the Neuropsychiatric Inventory Questionnaire. Emotional state was examined according to the Hamilton Depression Rating Scale, and neuromotor function was evaluated using the National Institutes of Health Stroke Scale, Barthel index, and the Activity of Daily Living test. After overnight fasting, blood samples were obtained to measure biochemistry indicators.

Results: MetS and its individual components were closely correlated with MoCA score. MetS patients had high levels of inflammation and a 3.542-fold increased odds ratio (OR) for cognitive impairment [95% confidence interval (CI): 1.972-6.361]. Of the individual MetS components, central obesity (OR 3.039; 95% CI: 1.839-5.023), high fasting plasma glucose (OR 1.915; 95% CI: 1.016-3.607), and type 2 diabetes (OR 2.241; 95% CI: 1.630-3.081) were associated with an increased incidence of cognitive impairment. Consistent and significant worsening in different neurological domains was observed with greater numbers of MetS components.

Conclusions: MetS was associated with worse cognitive function, neuromotor dysfunction, and neuropsychological symptoms among Chinese acute stroke patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Cognition
  • Cognitive Dysfunction / etiology*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / complications*
  • Middle Aged
  • Obesity / complications
  • Risk Factors
  • Stroke / complications*

Grants and funding

This work was supported by the Science and Technology Project of the Tianjin Municipal Health Bureau (http://www.tjwsj.gov.cn/html/WSJn/portal/index/index.htm) (2013KG121), the Tianjin Science and Technology Plan Foundation (http://www.tstc.gov.cn/) (grant no. 13ZCZDSY01600), the Special Fund of National Clinical and Medical Research (http://www.nsfc.gov.cn/) (grant no. L2014071), the Youth fund of National Nature Science Foundation of China (http://www.nsfc.gov.cn/) (grant no. 81301629). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.