Objective To investigate the effect of prediabetes on subcortical ischemic vascular cognitive impairment(SIVCI).Methods A retrospective analysis was performed on 242 patients with subcortical ischemic vascular disease(SIVD)who were admitted to the authors'hospital from April 2017 to July 2022.They were divided into vascular dementia(VaD)group,mild cognitive impairment(vMCI)group and no cognitive impairment(NoCI)group based on their cognitive function.Data of general clinical features,biochemical indexes,including fasting blood glucose and glycated hemoglobin,imaging indicators including the Fazekas score of white matter lesions(WMLs)and the degree of lacunar cerebral infarction were collected.Differences were compared by one-way analysis among three groups.The indicators with statistical significance(P＜0.05)among groups were included in the ordered Logistic regression equation to analyze the risk factors of SIVCI.Results The education level in VaD group and vMCI group was lower than that in NoCI group(P＜0.05),but the prevalence of hypertension and abnormal glucose regulation was higher than that in NoCI group(P＜0.05).There was no significant difference between VaD group and vMCI group in education level,prevalence of hypertension and prediabetes(P＞0.05),but the prevalence of diabetes in VaD group was higher than that in vMCI group(P＜0.05).The MMSE score in VaD group was lower than that in vMCI group and NoCI group(P＜0.05).The prevalence of severe WMLs in VaD group was higher than that in vMCI group and NoCI group(P＜0.05).The MMSE score in vMCI group was lower than that in NoCI group(P＜0.05),but there was no significant difference in the prevalence of severe WMLs between vMCI group and NoCI group(P＞0.05).Ordered Logistic regression analysis suggested diabetes[OR(95％CI)=2.921(1.636-5.215),P=0.001],prediabetes[OR(95％CI)=2.743(1.461-5.150],low education level[OR(95％CI)=0.861(0.811-0.914),P=0.001],history of hypertension[OR(95％CI)=1.867(1.089-3.201),P=0.023],and severe WMLs[OR(95％CI)=2.227(1.344-3.690),P=0.002]were all risk factors for SIVCI in SIVD patients.Conclusions Prediabetes and diabetes are risk factors for cognitive impairment in patients with SIVD in addition to low education,history of hypertension,and severe WMLs.Early screening of glucose metabolism and intervention of blood glucose in the prediabetes stage can help preventing SIVCI in patients with SIVD.
维普
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