Case Control Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Dec 19, 2023; 13(12): 985-994
Published online Dec 19, 2023. doi: 10.5498/wjp.v13.i12.985
Diagnostic and prognostic implications of non-high-density lipoprotein cholesterol and homocysteine levels for cognitive impairment in thalamic infarction
Shan-Yao Zhu, Wei Ge, Huan Zhang
Shan-Yao Zhu, Wei Ge, Huan Zhang, Department of Internal Medicine-Neurology, Chaohu Hospital Affiliated to Anhui Medical University, Hefei 238000, Anhui Province, China
Author contributions: Zhu SY and Zhang H conceived and designed the study; Zhu SY and Ge W guided the study; Zhu SY and Zhang H collected the clinical date; Zhu SY and Zhang H analyzed the data; All authors drafted and revised the manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Chaohu Hospital Affiliated to AnhuiMedical University, Approval No. KYXM-202208-011.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shan-Yao Zhu, Doctor, Chief Physician, Department of Internal Medicine-Neurology, Chaohu Hospital Affiliated to Anhui Medical University, No. 64 Chaohu North Road, Hefei 238000, Anhui Province, China. zsydoc@126.com
Received: September 14, 2023
Peer-review started: September 14, 2023
First decision: October 8, 2023
Revised: November 6, 2023
Accepted: December 2, 2023
Article in press: December 2, 2023
Published online: December 19, 2023
Processing time: 96 Days and 3.2 Hours
ARTICLE HIGHLIGHTS
Research background

In patients with thalamic infarction, the blood vessels of multiple nuclei are abnormally blocked, affecting the body and thus the thalamus. Abnormal Homocysteine (Hcy) levels are believed to be related to cognitive impairment in patients with thalamic infarction. Meanwhile, there is a positive correlation between non-high-density lipoprotein cholesterol (non-HDL-C) levels and cognitive impairment in lacunar cerebral infarction.

Research motivation

The analysis of the impact of independent risk factors, especially Hcy levels, on the prognosis of patients with thalamic infarction and the formulation of relevant prevention measures carries great clinical implications for improving patient outcomes. In addition, the value of changes in non-HDL-C levels in predicting the prognosis of patients with thalamic infarction deserves investigation.

Research objectives

To provide a reference for the clinical development of preventive measures to improve the prognosis of patients with thalamic infarction and to efficiently diagnose cognitive impairment in such patients.

Research methods

Eighty patients with thalamic infarction were included and divided into a group with cognitive impairment [Montreal Cognitive Assessment (MoCA) score: < 26] and a group without (MoCA score: 26-30), depending on their MoCA scores. In addition, 50 concurrent healthy controls were selected as a control group. Correlations of the non-HDL-C and Hcy levels with the MoCA score and receiver operating characteristic curve were observed. Serum non-HDL-C and Hcy levels were further analyzed. Furthermore, patients were grouped as a good prognosis group [Modified Rankin Scale (MRS) score: ≤ 2] and a poor prognosis group (MRS score: > 2) according to the MRS score, and the clinical characteristics were comparatively analyzed.

Research results

There was a certain relationship between non-HDL-C and Hcy levels and cognitive function in patients, with higher non-HDL-C and Hcy levels indicating worse cognitive function of patients. Pearson correlation analysis also identified an association between non-HDL-C and Hcy levels and MoCA scores. Specifically, the higher the levels of non-HDL-C and Hcy, the lower the MoCA score, indicating more severe cognitive impairment in patients.

Research conclusions

Non-HDL-C and Hcy levels are positively correlated with cognitive impairment in patients with thalamic infarction, indicating their potential to diagnose cognitive impairment in such patients. In addition, their combined detection contributes to higher diagnostic efficacy.

Research perspectives

Simultaneous detection of non-HDL-C and Hcy levels can assist in the diagnosis of cognitive dysfunction in patients with thalamic infarction, which is of great clinical significance for improving the prognosis of these patients.