Effects of GLP-1 receptor agonists on cognitive function in patients with type 2 diabetes mellitus after acute ischemic stroke

doi:10.3969/j.issn.1006-7795.2024.06.013

Abstract

Abstract: Objective To investigate the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RA) on cognitive function in patients with type 2 diabetes mellitus (T2DM) after acute ischemic stroke. Methods A case-control study was conducted, involving 249 patients with acute ischemic stroke combined with T2DM. The patients were divided into two groups based on whether they had regularly used GLP-1 RA (with semaglutide as a representative) or not (insulin therapy). Baseline demographic characteristics, biochemical test results, and blood glucose monitoring levels during hospitalization were recorded. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and patients with a score below 26 were excluded. A total of 219 eligible patients were followed up 3 months after the stroke, and cognitive function was reassessed using the MoCA score, with a score below 22 indicating post-stroke cognitive impairment (PSCI). Binary Logistic regression analysis was used to compare the cognitive function scores between the two groups and to analyze the differences in ankle-brachial index and derived time in range (dTIR) between patients with different scores. Results By the end of the study, 32 out of 110 patients in the GLP-1 RA group developed PSCI, with an incidence rate of 29.09%. In the non-GLP-1 RA group, 45 out of 109 patients developed PSCI, with an incidence rate of 41.28%. Cognitive function scores showed that semaglutide intervention significantly reduced the incidence of PSCI. Binary Logistic regression analysis indicated that the odds ratio for semaglutide intervention was 2.285, while that for the dTIR parameter was 0.985. Conclusions GLP-1 RA therapy can reduce the severity of PSCI in patients with ischemic stroke combined with T2DM.

Key words: glucagon-like peptide-1 receptor agonists, acute ischemic stroke, cognitive function, type 2 diabetes mellitus, semaglutide

CLC Number:

R743.3

Li Xingmao, Li Xiu, Wang Ting, Zhao Xin, Wang Deyang, Shang Haiyan, Zhao Yongmei, Li Sen. Effects of GLP-1 receptor agonists on cognitive function in patients with type 2 diabetes mellitus after acute ischemic stroke[J]. Journal of Capital Medical University, 2024, 45(6): 1029-1037.

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https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2024/V45/I6/1029

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