Chen Zhu1, Guangzong Li1, Zhiyu Lv2, Jing Li3, Xiangming Wang1, Jie Kang1, Cheng Zhan4. 1. Department of Neurology, Central Hospital of Panzhihua City, No. 34 Yikang Street, Panzhihua, 617000, Sichuan Province, China. 2. Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China. 3. Department of Clinical Laboratory, Central Hospital of Panzhihua City, Panzhihua, 617000, Sichuan Province, China. 4. Department of Neurology, Central Hospital of Panzhihua City, No. 34 Yikang Street, Panzhihua, 617000, Sichuan Province, China. zhancheng_neuro@126.com.
Abstract
BACKGROUND AND AIMS: Post-stroke cognitive impairment (PSCI) is a clinical condition arising from stroke and causes significant changes to memory, thinking, and behavior. Trimethylamine-N-oxide (TMAO), the metabolite produced by gut microbiota, has mechanistic relevance to atherosclerotic diseases. This study aimed to investigate whether an association existed between elevated plasma TMAO levels and PSCI. METHODS: Consecutive patients with acute ischemic stroke were prospectively enrolled during Jan. 2017 to Dec. 2017. TMAO concentration was measured within 24 h after admission. PSCI was assessed using the Mini-Mental State Examination (MMSE) score after 1 year and defined as MMSE score ≤ 26. Binary logistic regression analysis was used to determine the contribution of TMAO level in the prediction of PSCI. RESULTS: Of the 256 patients studied (age, 67.1 ± 11.0 years; male, 54.3%), 86 (33.6%) patients were diagnosed as PSCI. The mean TMAO level was 5.6 ± 2.4 μM, with quartile level as follows: < 3.9 μM (first quartile), 3.9-5.1 μM (second quartile), 5.2-7.4 μM (third quartile), and > 7.4 μM (fourth quartile). After controlling for potential confounders, multivariable logistic analysis showed that higher level of plasma TMAO was an independent predictor for cognitive impairment in post-stroke patients (the quartile 1 was used as reference, the quartile 4 odds ratio, 3.304; 95% confidence intervals, 1.335-8.178; P = 0.010). CONCLUSIONS: This study demonstrated that increasing plasma level of TMAO may be associated with PSCI.
BACKGROUND AND AIMS: Post-stroke cognitive impairment (PSCI) is a clinical condition arising from stroke and causes significant changes to memory, thinking, and behavior. Trimethylamine-N-oxide (TMAO), the metabolite produced by gut microbiota, has mechanistic relevance to atherosclerotic diseases. This study aimed to investigate whether an association existed between elevated plasma TMAO levels and PSCI. METHODS: Consecutive patients with acute ischemic stroke were prospectively enrolled during Jan. 2017 to Dec. 2017. TMAO concentration was measured within 24 h after admission. PSCI was assessed using the Mini-Mental State Examination (MMSE) score after 1 year and defined as MMSE score ≤ 26. Binary logistic regression analysis was used to determine the contribution of TMAO level in the prediction of PSCI. RESULTS: Of the 256 patients studied (age, 67.1 ± 11.0 years; male, 54.3%), 86 (33.6%) patients were diagnosed as PSCI. The mean TMAO level was 5.6 ± 2.4 μM, with quartile level as follows: < 3.9 μM (first quartile), 3.9-5.1 μM (second quartile), 5.2-7.4 μM (third quartile), and > 7.4 μM (fourth quartile). After controlling for potential confounders, multivariable logistic analysis showed that higher level of plasma TMAO was an independent predictor for cognitive impairment in post-strokepatients (the quartile 1 was used as reference, the quartile 4 odds ratio, 3.304; 95% confidence intervals, 1.335-8.178; P = 0.010). CONCLUSIONS: This study demonstrated that increasing plasma level of TMAO may be associated with PSCI.
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