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Elevated Plasma Level of D-dimer Predicts the High Risk of Early Cognitive Impairment in Type 2 Diabetic Patients as Carotid Artery Plaques become Vulnerable or Get Aggravated

[ Vol. 16 , Issue. 5 ]

Author(s):

Jiaqi Wang, Rong Huang, Sai Tian, Hongyan Lin, Dan Guo, Ke An and Shaohua Wang*   Pages 396 - 404 ( 9 )

Abstract:


Background and Objective: D-dimer prompts fibrinolysis system, which is involved in Alzheimer’s disease and the complications of type 2 diabetic patients, especially among those with carotid artery plaques. Hence, this study aims to investigate the role of D-dimer in early cognitive impairment among type 2 diabetic patients with carotid artery plaques.

Methods: A total of 175 Chinese patients with type 2 diabetes were recruited and divided into two groups according to the Montreal Cognitive Assessment score. Demographic data were collected, plasma D-dimer was tested through VIDAS D-dimer New, neuropsychological tests were examined, and carotid artery plaques were detected by ultrasound and further stratified by vulnerability and level.

Results: A total of 67 types 2 diabetic patients with Mild Cognitive Impairment (MCI) displayed significantly increased plasma D-dimer levels compared with their health-cognition controls (p = 0.011). Plasma D-dimer concentration was negatively related with Digit Span Test scores in diabetic patients with vulnerable plaques (r=-0.471, p=0.023) and Stroop Color Word Test C (number) in diabetic patients with stable plaques (r=-0.482, p<0.001). Multivariable regression analysis further showed that D-dimer concentration was an independent factor of diabetic MCI with carotid artery plaque (p=0.005), and D-dimer concentration especially contributed to the high risk of MCI with vulnerable plaques (p=0.028) or high levels of carotid plaque (p=0.023).

Conclusion: Elevated D-dimer level predicts the high risk of early cognitive impairment in type 2 diabetic patients with carotid artery plaques, especially vulnerable plaques or high levels of carotid plaques.

Keywords:

Carotid artery plaques, vulnerable plaques, D-dimer, fibrinolysis system, mild cognitive impairment, type 2 diabetes mellitus.

Affiliation:

Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009



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