Gamma-glutamyl transferase levels are associated with the occurrence of post-stroke cognitive impairment: a multicenter cohort study

Siqi Li,Xianglong Xiang,Yumei Zhang,Xiaoling Liao,Yuesong Pan

doi:10.1186/s12883-022-02587-4

Abstract

BackgroundGamma-glutamyl transferase (GGT) is involved in maintenance of physiological concentrations of glutathione in cells, and protects them from oxidative stress-induced damage. However, its role in post-stroke cognitive impairment (PSCI) remains unknown. Here, we investigated the effects of serum GGT on PSCI.MethodsWe conducted a prospective, multicenter cohort study. A total of 1, 957 participants with a minor ischemic stroke or transient ischemic attack whose baseline GGT levels were measured were enrolled from the Impairment of Cognition and Sleep (ICONS) study of the China National Stroke Registry-3 (CNSR-3). They were categorized into four groups according to quartiles of baseline GGT levels. Cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA) approach. Multiple logistic regression models were performed to evaluate the relationship between GGT and PSCI at 3 months follow-up.ResultsAmong the 1957 participants, 671 (34.29%) patients suffered PSCI at 3 months follow-up. The highest GGT level quartile group exhibited a lower risk of PSCI in the fully adjusted model [OR (95% CI): 0.69 (0.50-0.96)], relative to the lowest group. Moreover, incorporation of GGT to the conventional model resulted in slight improvements in PSCI outcomes after 3 months (NRI: 12.00%; IDI: 0.30%).ConclusionsSerum GGT levels are inversely associated with the risk of PSCI, with extremely low levels being viable risk factors for PSCI.

Highlights

Gamma-glutamyl transferase (GGT) is involved in maintenance of physiological concentrations of glutathione in cells, and protects them from oxidative stress-induced damage
Study population All participants with a minor ischemic stroke or transient ischemic attack were selected from the Impairment of Cognition and Sleep (ICONS) study of the China National Stroke Registry-3 (CNSR-3)
Baseline characteristics Among the 2625 participants in the ICONS study, 1957 participants with complete baseline GGT levels and 3-months follow-up were enrolled (Fig. 1). They were divided into four groups according to the quartile of GGT levels, namely < 17, 17 ~ 24, 24 ~ 37, and ≥ 37 U/L

Summary

Introduction

Gamma-glutamyl transferase (GGT) is involved in maintenance of physiological concentrations of glutathione in cells, and protects them from oxidative stress-induced damage. Its role in post-stroke cognitive impairment (PSCI) remains unknown. Stroke is a leading cause of disabilities and mortalities, affecting one in every four people [1,2,3]. Consensus Study (VICCCS), vascular cognitive impairment (VCI) refers to cognitive disorders caused by underlying vascular factors and can be associated with obvious cerebrovascular diseases [4]. Vascular depression can lead to decreased intracortical facilitation and disruption of glutamate neurotransmission, which plays a major role in synaptic plasticity, and might contribute to the cognitive deterioration [6,7,8].

Objectives

Methods

Results

Discussion

Conclusion