The association between plasma soluble triggering receptor expressed on myeloid cells 2 and cognitive impairment after acute ischemic stroke
The association between plasma soluble triggering receptor expressed on myeloid cells 2 and cognitive impairment after acute ischemic stroke
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髓系细胞2表达的血浆可溶性触发受体与急性缺血性脑卒中后认知障碍的关系
DOI：
10.1016/j.jad.2021.12.011
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发表时间：
2022
影响因子：
6.6
通讯作者：
Chongke Zhong
中科院分区：
文献类型：
--
作者：
Yinwei Zhu;Yu Zhao;Yaling Lu;Chongquan Fang;Qi Zhang;Jintao Zhang;Zhong Ju;Yonghong Zhang;Tan Xu;Chongke Zhong
背景研究表明，髓系细胞可溶性触发受体2（sTREM 2）在中枢神经系统病理和神经退行性疾病的发生发展中起着关键作用。本研究旨在前瞻性地探讨血浆sTREM 2水平和脑卒中后认知功能障碍（PSCI）之间的关联。方法中国急性缺血性脑卒中降压试验的599例连续急性缺血性脑卒中患者的sTREM 2测量结果最终纳入本分析。认知障碍定义为在3个月随访时测量的简易精神状态检查评分<25。二元逻辑回归被用来估计的比值比（OR）的血浆sTREM 2水平上的风险PSCI.ResultsOf 599参与者（平均年龄，60.0 ± 10.4岁;男性，70.5%），228（38.1%）患者被诊断为PSCI。血浆sTREM 2水平越高，PSCI的风险越高（趋势p <0.01）。在调整几个混杂因素后，对于PSCI，sTREM 2的最高四分位数与最低四分位数相比的OR为2.06（95%置信区间，1.20-3.53）。此外，将sTREM 2添加到具有既定风险因素的常规模型中显著改善了风险辨别（C-统计量从0.668增加到0.691，p = 0.02）和重新分类（净重新分类改善：32.2%，p < 0.001;综合辨别改善：结论血浆sTREM 2水平升高可能与PSCI有关，sTREM 2对PSCI有潜在的预测价值。
BackgroundPrevious researches have suggested that soluble triggering receptor expressed on myeloid cells 2 (sTREM2) plays a pivotal role in central nervous system pathologies and the development of neurodegenerative disorders. This study aimed to prospectively investigate the association between plasma sTREM2 levels and post-stroke cognitive impairment (PSCI).MethodsA sample of 599 consecutive acute ischemic stroke patients with sTREM2 measurements from the China Antihypertensive Trial in Acute Ischemic Stroke were eventually included in this analysis. Cognitive impairment was defined as a score of <25 for Mini-Mental State Examination, measured at 3-month follow up. Binary logistic regression was used to estimate the odds ratios (ORs) of plasma sTREM2 levels on the risk of PSCI.ResultsOf the 599 participants (mean age, 60.0 ± 10.4 years; male, 70.5%), 228 (38.1%) patients were diagnosed as PSCI. The risk of PSCI elevated significantly with higher plasma sTREM2 levels (pfor trend <0.01). After adjusting for several confounding factors, the ORs for the highest quartile of sTREM2 compared with the lowest quartile was 2.06 (95% confidence interval, 1.20–3.53) for PSCI. Moreover, the addition of sTREM2 to the conventional model with established risk factors significantly improved risk discrimination (C-statistics increased from 0.668 to 0.691,p= 0.02) and reclassification (net reclassification improvement: 32.2%,p< 0.001; integrated discrimination improvement: 1.3%,p= 0.01) for PSCI.LimitationsResults might be subject to selective bias and potential confounding.ConclusionsThe present study demonstrated that elevated level of plasma sTREM2 may be associated with PSCI, and sTREM2 has potential value in predicting PSCI.