Inflammation and cognitive dysfunction in type 2 diabetic carotid endarterectomy patients.
Inflammation and cognitive dysfunction in type 2 diabetic carotid endarterectomy patients.
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DOI：
10.2337/dc12-2507
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发表时间：
2013-10
期刊：
影响因子：
16.2
通讯作者：
Connolly ES
中科院分区：
文献类型：
--
作者：
Heyer EJ;Mergeche JL;Bruce SS;Connolly ES
2型糖尿病患者颈动脉内膜剥脱术(CEA)后脑血管疾病发生率高，炎症升高，认知功能障碍的风险高。为了阐明炎症与2型糖尿病患者认知功能障碍风险之间的关系，我们旨在确定全身炎性标志物水平升高是否与CEA后1天的认知功能障碍有关。在这项单中心队列研究中，115名2型糖尿病CEA患者和156名参考外科患者在书面知情同意下被招募。所有患者都接受了广泛的神经心理测试。检测患者术前单核细胞计数、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)、细胞间黏附分子1(ICAM 1)和基质金属蛋白酶9(MMP9)活性。在建立的多因素Logistic回归模型中，单核细胞计数(优势比[OR]1.76[95%CI1.17-2.93]；P=0.005)和C反应蛋白(OR1.17[1.10-1.29]；P<；0.001)与2型糖尿病患者CEA术后1天发生认知功能障碍的风险显著相关。术前全身炎症标志物水平升高的2型糖尿病患者在CEA后1天表现出更多的认知功能障碍。这些观察结果对接受CEA颈动脉血运重建术的高危外科患者的术前医疗处理有一定的指导意义。
Type 2 diabetic patients have a high incidence of cerebrovascular disease, elevated inflammation, and high risk of developing cognitive dysfunction following carotid endarterectomy (CEA). To elucidate the relationship between inflammation and the risk of cognitive dysfunction in type 2 diabetic patients, we aim to determine whether elevated levels of systemic inflammatory markers are associated with cognitive dysfunction 1 day after CEA. One hundred fifteen type 2 diabetic CEA patients and 156 reference surgical patients were recruited with written informed consent in this single-center cohort study. All patients were evaluated with an extensive battery of neuropsychometric tests. Preoperative monocyte counts, HbA1c, C-reactive protein (CRP), intercellular adhesion molecule 1, and matrix metalloproteinase 9 activity levels were obtained. In a multivariate logistic regression model constructed to identify predictors of cognitive dysfunction in type 2 diabetic CEA patients, each unit of monocyte counts (odds ratio [OR] 1.76 [95% CI 1.17–2.93]; P = 0.005) and CRP (OR 1.17 [1.10–1.29]; P < 0.001) was significantly associated with higher odds of developing cognitive dysfunction 1 day after CEA in type 2 diabetic patients. Type 2 diabetic patients with elevated levels of preoperative systemic inflammatory markers exhibit more cognitive dysfunction 1 day after CEA. These observations have implications for the preoperative medical management of this high-risk group of surgical patients undergoing carotid revascularization with CEA.
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影响因子：
8.3
作者：
Heyer, Eric J.;Mergeche, Joanna L.;Connolly, E. Sander
通讯作者：
Connolly, E. Sander
影响因子：
4.8
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4.8
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8.3
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影响因子：
11.1
作者：
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通讯作者：
Taskinen, MR