The Association of Glycemic Gap with Cognitive Function After Ischemic Stroke or Transient Ischemic Attack

Yan Min,1 Qin Xu,1,2 Yongjun Wang,1– 3 Zixiao Li1,2,4 1Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China; 3Center of Stroke, Beiji...

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Main Authors: Min Y, Xu Q, Wang Y, Li Z
Format: Article
Language:English
Published: Dove Medical Press 2025-07-01
Series:Neuropsychiatric Disease and Treatment
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Online Access:https://www.dovepress.com/the-association-of-glycemic-gap-with-cognitive-function-after-ischemic-peer-reviewed-fulltext-article-NDT
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author Min Y
Xu Q
Wang Y
Li Z
author_facet Min Y
Xu Q
Wang Y
Li Z
author_sort Min Y
collection DOAJ
description Yan Min,1 Qin Xu,1,2 Yongjun Wang,1– 3 Zixiao Li1,2,4 1Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China; 3Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People’s Republic of China; 4Chinese Institute for Brain Research, Beijing, People’s Republic of ChinaCorrespondence: Yongjun Wang, Beijing TianTan Hospital, Capital Medical University, Beijing, People’s Republic of China, Tel +86 010 59978351, Email yongjunwang@ncrcnd.org.cn Zixiao Li, Beijing TianTan Hospital, Capital Medical University, Beijing, People’s Republic of China, Tel +86 010 59978351, Email lizixiao2008@hotmail.comBackground: Glycemic gap (GG), as a measure of an acute derangement in glucose level in response to an active disease state, has been found to be associated with adverse outcomes in many diseases. This study aimed to determine the relationship of GG with cognitive function after ischemic stroke or transient ischemic attack (TIA).Methods: Patients included were enrolled from a subgroup of China National Stroke Registry-III (CNSR-III). Cognitive function was assessed by the Beijing edition of the Montreal cognitive assessment (MoCA) scale. Post-stroke cognitive impairment (PSCI) was diagnosed as a MoCA score≤ 22. Post-stroke cognitive decline (PSCD) was defined as a decrease of > 2 points on the MoCA score between the 3-month and 1-year assessments. GG was calculated using admission blood glucose minus hemoglobin A1c-derived average blood glucose. Multivariable logistic regression analysis was used to evaluate the correlation between GG and cognitive function.Results: We enrolled 767 patients with a median age of 60 years old, including 247 (32.2%) patients with PSCI in 3 months, 228 (29.73%) with PSCI in 1 year, and 166 (21.64%) patients with PSCD. The highest GG levels were related to PSCI in 3 months after adjusted for multiple potential confounders (adjusted odd ratio (OR): 2.021, 95% CI: 1.055– 3.869, P=0.0338), but not in patients with PSCI in 1 year or PSCD. No significant interactions for the impact on PSCI were observed in subgroups (P interaction > 0.05 for all).Conclusion: Our findings show that GG is associated with acute post-stroke cognitive impairment, but not with the long-term cognitive impairment or cognitive decline.Keywords: cognitive function, glycemic gap, stroke, transient ischemic attack
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spelling doaj-art-4daa4753ba3449138e3a20e8fbaa113f2025-08-20T03:13:05ZengDove Medical PressNeuropsychiatric Disease and Treatment1178-20212025-07-01Volume 21Issue 114251433104960The Association of Glycemic Gap with Cognitive Function After Ischemic Stroke or Transient Ischemic AttackMin Y0Xu Q1Wang Y2Li Z3Beijing Tiantan hospitalBeijing Tiantan hospitalBeijing Tiantan hospitalBeijing Tiantan hospitalYan Min,1 Qin Xu,1,2 Yongjun Wang,1– 3 Zixiao Li1,2,4 1Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China; 3Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People’s Republic of China; 4Chinese Institute for Brain Research, Beijing, People’s Republic of ChinaCorrespondence: Yongjun Wang, Beijing TianTan Hospital, Capital Medical University, Beijing, People’s Republic of China, Tel +86 010 59978351, Email yongjunwang@ncrcnd.org.cn Zixiao Li, Beijing TianTan Hospital, Capital Medical University, Beijing, People’s Republic of China, Tel +86 010 59978351, Email lizixiao2008@hotmail.comBackground: Glycemic gap (GG), as a measure of an acute derangement in glucose level in response to an active disease state, has been found to be associated with adverse outcomes in many diseases. This study aimed to determine the relationship of GG with cognitive function after ischemic stroke or transient ischemic attack (TIA).Methods: Patients included were enrolled from a subgroup of China National Stroke Registry-III (CNSR-III). Cognitive function was assessed by the Beijing edition of the Montreal cognitive assessment (MoCA) scale. Post-stroke cognitive impairment (PSCI) was diagnosed as a MoCA score≤ 22. Post-stroke cognitive decline (PSCD) was defined as a decrease of > 2 points on the MoCA score between the 3-month and 1-year assessments. GG was calculated using admission blood glucose minus hemoglobin A1c-derived average blood glucose. Multivariable logistic regression analysis was used to evaluate the correlation between GG and cognitive function.Results: We enrolled 767 patients with a median age of 60 years old, including 247 (32.2%) patients with PSCI in 3 months, 228 (29.73%) with PSCI in 1 year, and 166 (21.64%) patients with PSCD. The highest GG levels were related to PSCI in 3 months after adjusted for multiple potential confounders (adjusted odd ratio (OR): 2.021, 95% CI: 1.055– 3.869, P=0.0338), but not in patients with PSCI in 1 year or PSCD. No significant interactions for the impact on PSCI were observed in subgroups (P interaction > 0.05 for all).Conclusion: Our findings show that GG is associated with acute post-stroke cognitive impairment, but not with the long-term cognitive impairment or cognitive decline.Keywords: cognitive function, glycemic gap, stroke, transient ischemic attackhttps://www.dovepress.com/the-association-of-glycemic-gap-with-cognitive-function-after-ischemic-peer-reviewed-fulltext-article-NDTCognitive functionGlycemic GapStrokeTransient ischemic attack
spellingShingle Min Y
Xu Q
Wang Y
Li Z
The Association of Glycemic Gap with Cognitive Function After Ischemic Stroke or Transient Ischemic Attack
Neuropsychiatric Disease and Treatment
Cognitive function
Glycemic Gap
Stroke
Transient ischemic attack
title The Association of Glycemic Gap with Cognitive Function After Ischemic Stroke or Transient Ischemic Attack
title_full The Association of Glycemic Gap with Cognitive Function After Ischemic Stroke or Transient Ischemic Attack
title_fullStr The Association of Glycemic Gap with Cognitive Function After Ischemic Stroke or Transient Ischemic Attack
title_full_unstemmed The Association of Glycemic Gap with Cognitive Function After Ischemic Stroke or Transient Ischemic Attack
title_short The Association of Glycemic Gap with Cognitive Function After Ischemic Stroke or Transient Ischemic Attack
title_sort association of glycemic gap with cognitive function after ischemic stroke or transient ischemic attack
topic Cognitive function
Glycemic Gap
Stroke
Transient ischemic attack
url https://www.dovepress.com/the-association-of-glycemic-gap-with-cognitive-function-after-ischemic-peer-reviewed-fulltext-article-NDT
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