Correlation Between Impaired Glucose Regulation,HIF-1α,GLUT1 And Cognitive Impairment In With Inschemic Cerebral Small Vessel Disease

Objectives Cerebral small vessel disease(CSVD)patients were examined by oral glucose tolerance test(OGTT),and serum hypoxia inducible factor-1α(HIF-1α)and glucose transpoter1(GLUT1)were detected to explore the correlation between impaired glucose regulation(IGR)and HIF-1α and GLUT1 with cognitive impairment in ischemic cerebral small vessel disease.It provides basis for early recognition and diagnosis of cognitive impairment in ischemic small vascular disease.Methods A total of 455 non-diabetic patients with ischemic CSVD who were hos pitalized in the Department of Neurology,Affiliated Hospital of North China Unive rsity of Science and Technology from September 2019 to October 2021 were select ed to measure their cognitive level using the Montreal Cognitive Assessment Scale(Mo CA).According to the evaluation of cognitive scores,patients with scores of ≥ 26 points were included in the group of normal cognitive function(238 cases),wit h scores <The cognitive impairment group was further divided into mild cognitiv e impairment group(n=97),moderate cognitive impairment group(n=68)and severe cognitive impairment group(n=52).OGTT test and serum HIF-1α and GLUT1 lev els were performed in all patients.To analyze the correlation between impaired gluc ose regulation,HIF-1α,GLUT1 and cognitive impairment in patients with ischemic CSVD.Results 1 Compared with the cognitive impairment group,age,UA,INS and FCP levels of the cognitive impairment group were higher than those of the cognitive impairment group,and the differences were statistically significant(P<0.05).2 Comparison of IGR between the cognitive impairment group and the cognitive normal group showed that the proportion of IGR in the cognitive impairment group increased,and the difference was statistically significant(P<0.05).Correlation analysis between IGR and Mo Ca scores in cognitive impairment group of patients with ischemic small vessel disease showed that dysregulation of glucose was negatively correlated with scores of visual spatial and executive ability,attention,language,delayed recall and orientation in patients with ischemic small vessel disease,and the differences were statistically significant(P<0.05).3 Compared with the cognitively normal group,HIF-1α increased and GLUT1 decreased in the cognitively impaired group,and the differences were statistically significant(P<0.05).The association between serum HIF-1α and GLUT1 and vascular cognitive impairment in patients with ischemic CSVD was analyzed using HIF-1 α and GLUT1≥ population mean as exposure respectively.The results showed that HIF-1 α and GLUT1 were associated with vascular cognitive impairment in patients with ischemic small vessel disease,and increased HIF-1α and decreased GLUT1 levels increased the risk of cognitive impairment in patients with ischemic CSVD(P<0.05).4 Multivariate logistic regression analysis showed that IGR,HIF-1α and GLUT1 were independent risk factors for cognitive impairment in patients with ischemic CSVD after controlling for other factors(P<0.05).5 Compared with the mild cognitive impairment group,the proportion of IGR,HIF-1α level and GLUT1 level in the moderate and severe cognitive impairment group were increased,and the differences were statistically significant(P<0.05).Compared with moderate cognitive impairment group,HIF-1 α level increased,GLUT1 level decreased,and IGR proportion increased in severe cognitive impairment group,with statistically significant differences(P<0.05).6 Serum HIF-1α level in IGR group was higherthan that in normal blood glucose group,GLUT1 level was lower than that in normal blood glucose group,the difference was statistically significant(P<0.05).Conclusions 1 IGR is associated with vascular cognitive impairment and the degree of cognitive impairment in patients with ischemic small vascular disease,especially in the areas of visuospatial and executive ability,attention,language,delayed recall,orientation and so on.IGR may be involved in the occurrence and development of cognitive impairment in ischemic small vascular disease.2 HIF-1 α was positively correlated with vascular cognitive impairment in patients with ischemic small vessel disease.The level of HIF-1α increased and the degree of cognitive impairment increased.3 GLUT1 was negatively correlated with vascular cognitive impairment in patients with ischemic small vascular disease.The level of GLUT1 decreased and the degree of cognitive impairment increased.4 Compared with the group without IGR,HIF-1 α and GLUT1 decreased in patients with ischemic CSVD with IGR,suggesting that THERE may be bidirectional influence between IGR and HIF-1α and GLUT1 responsive pathological changes in CSVD.Figure 0;Table 13;Reference 123...