Elevated serum alkaline phosphatase as a predictor of cognitive impairment in patients with acute ischaemic stroke: A retrospective cohort study

Li, Huimian; Liu, Yanru; Liu, Chao; Xue, Mengzhou

doi:10.1016/j.archger.2020.104104

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…[12] Jia et al retrospectively investigated the relationship between ALP levels and cognitive function in acute ischemic stroke patients and found that ALP levels were conversely associated with cognitive function. [13] There are several differences between our study and these previous studies. First, the study population was different; our study was performed among postoperative patients, and previous studies were performed among the general population or ischemic stroke patients.…”

Section: Discussioncontrasting

confidence: 77%

“…Using a cross-sectional study, Boccardi et al [12] reported that serum ALP activity is increased in subjective cognitive decline and inversely correlates with cognitive functions in the general population. Jia et al [13] also found that elevated serum ALP could be a predictor of cognitive impairment in patients with acute ischemic stroke. However, little is known about the association between serum ALP levels and POCD after general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

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Elevated serum alkaline phosphatase correlates with postoperative cognitive dysfunction: A retrospective cohort study based on STROBE statement

Zhao²,

Shi³

et al. 2022

Medicine

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Little is known about the association between serum alkaline phosphatase (ALP) levels and postoperative cognitive dysfunction (POCD) after general anesthesia. Thus, we investigated the association of serum ALP levels with POCD in patients who underwent surgery with general anesthesia in a retrospective cohort study. We retrospectively collected data from patients who underwent surgery with general anesthesia between May 2016 and June 2020. Serum ALP activity was detected using a p-nitrophenyl phosphate assay. Pre-and postoperative cognitive function were evaluated using the Chinese version of the Mini-Mental State Examination. Univariate and multivariate logistic regression were used to explore the effect of ALP on cognitive function. The incidence of POCD was 13.5%. Compared with the control group, the POCD group had higher ALP levels. The neuropsychological test results suggested that the scores of most items were lower in the POCD group than in the non-POCD group. Univariate logistic regression indicated that increased ALP levels were significantly associated with cognitive dysfunction (odds ratio = 1.15, 95% confidence interval: 1.13-1.18, P = .000). Multivariate regression showed that elevated ALP was still associated with POCD after adjusting for confounding factors (odds ratio = 1.16, 95% confidence interval: 1.13-1.18, P = .000). The spline regression model indicated the dose-response associations between ALP level and POCD risk (P for nonlinear trend < .001). Our study indicated that elevated serum ALP was an independent predictive factor of POCD at the 3-month follow-up. The occurrence of POCD could be associated with inflammatory status.

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Section: Discussioncontrasting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Elevated serum alkaline phosphatase correlates with postoperative cognitive dysfunction: A retrospective cohort study based on STROBE statement

Zhao²,

Shi³

et al. 2022

Medicine

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“…PSCI has always been a hot research topic, and PSCI is closely related to poor stroke outcomes [15]. Previous studies have reported some factors associ-ated with PSCI, such as, alkaline phosphatase, vitamin D and endostatin, but few studies have reported how to reduce the incidence of PSCI [16][17][18]. In our study, we reported that HUK can reduce the incidence of PSCI compared with the control group, providing treatment for the prevention of high-risk PSCI patients.…”

Section: Discussionmentioning

confidence: 53%

Human urinary kallidinogenase decreases the incidence of post-stroke cognitive impairment in acute ischemic stroke patients

Xu¹,

Chen²,

Shang³

2022

J. Integr. Neurosci.

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Background: Post-stroke cognitive impairment (PSCI) is a common symptom of stroke and affects the quality of life and prognosis of stroke survivors. In our study, we evaluated the efficacy of Human urinary kallidinogenase (HUK) on cognitive function in acute ischemic stroke (AIS) patients, and discussed the role of cystatin C (CysC) in improving PSCI. Methods: We enrolled a retrospective cohort with prospective follow-up. From August 2020 to May 2021, 130 patients completed the final follow-up. Among them, 61 patients received HUK combined with basic treatment, which we defined as the HUK group, and 69 patients received basic treatment, which we defined as the control group. We compared the changes of CysC, urea nitrogen and creatinine levels after one week of treatment between the two groups. Cognitive function was assessed by Montreal Cognitive Assessment (MoCA) at 3-month after AIS. Results: No significant differences in demographic data and Laboratory tests between two groups before treatment. A total of 67 patients (51.5%) were diagnosed as PSCI at 3-month follow-up, among which, 25 patients were in the HUK group and 42 patients were in the control group. Compared with the control group (60.9%), the incidence of PSCI was significantly lower in the HUK group (41.0%). In addition, the serum CysC level after a week of treatment significantly decreased from baseline in HUK group (p = 0.037), in comparison, the serum CysC level in the control group was basically unchanged (p = 0.951). There was a significant negative correlation between MoCA score and the level of CysC after treatment (p = 0.003, r = -0.373). Conclusions: HUK can reduce the risk of PSCI at 3-month in AIS patients. The decrease of serum CysC level may be one of the mechanisms by which HUK reduces the incidence of PSCI.

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“…CRP samples were derived from the serum (eight studies) and plasma (one study) of stroke patients in the acute phase. Moreover, the overall quality of the studies included in this meta-analysis was moderate to high, and the quality analysis assessment via the NOS (Supplementary Content S2) revealed that all of the studies achieved ratings of more than six stars, with two papers rated as seven stars [24,25], six rated as eight stars [13][14][15][26][27][28], and one rated as nine stars [29]. Nine studies comparing peripheral CRP concentrations between CD and non-CD patients (1695 CD patients and 2198 non-CD patients) were used for the meta-analyses.…”

Section: Characteristics Of Included Studies and Quality Assessmentsmentioning

confidence: 99%

C-Reactive Protein Levels and Cognitive Decline following Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

et al. 2023

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Cognitive decline (CD) is devastating with a high incidence in patients after stroke. Although some studies have explored underlying associations between C-reactive protein (CRP) levels and cognitive decline after stroke, consistent results have not been obtained. Therefore, this meta-analysis aimed to explore whether or not higher levels of C-reactive proteins were associated with an increased risk of cognitive decline after stroke. To this end, PubMed, Embase, the Cochrane Library, and Web of Science were searched for eligible studies, and pooled effect sizes from eligible studies were calculated using random effect models. Furthermore, subgroups were established and meta-regression analyses were performed to explain the causes of heterogeneity. Eventually, nine studies with 3893 participants were included. Our statistical results suggested that the concentrations of peripheral CRP may be significantly increased for CD patients after stroke, compared to those of non-CD patients. Subgroup analyses showed that CRP was higher in CD than that in non-CD patients when the mini-mental state examination was used. A higher level of CRP in the acute phase of ischemic stroke may suggest an increased risk of CD after stroke. However, these results should be cautiously interpreted because of the limited sample sizes and the diversity of potential confounders in the studies included in this meta-analysis.

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Elevated serum alkaline phosphatase as a predictor of cognitive impairment in patients with acute ischaemic stroke: A retrospective cohort study

Cited by 6 publications

References 32 publications

Elevated serum alkaline phosphatase correlates with postoperative cognitive dysfunction: A retrospective cohort study based on STROBE statement

Elevated serum alkaline phosphatase correlates with postoperative cognitive dysfunction: A retrospective cohort study based on STROBE statement

Human urinary kallidinogenase decreases the incidence of post-stroke cognitive impairment in acute ischemic stroke patients

C-Reactive Protein Levels and Cognitive Decline following Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

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