Research on the value of methionine loading test in the mild vascular cognitive impairment / 中华老年医学杂志

ABSTRACT

Objective To study the value of methionine loading test (MLT) in the mild vascular cognitive impairment (VCI) after acute cerebral infarction.Methods The fasting plasma homocystine (Hcy) level and homocystine level after MLT were measured by high-performance liquid chromatography methods.We chose 240 patients with normal level of fasting plasma Hcy (normal group),159 patients with normal level of Hcy after MLT,81 patients with hyperhomocysteinemia after MLT (hyperhomocysteinemia group),and 112 patients with fasting hyperhomocysteinemia (fasting hyperhomocysteinemia group) in this study.The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were conducted in normal,hyperhomocysteinemia and fasting hyperhomocysteinemia groups on admission,at 7d,14 d,30 d after treatment.Results Logistic regression analysis showed that the increased level of Hcy might be an independent risk factor for VCI [OR1.285,95％CI1.038-1.265,P＜0.05].The scores of MMSE and MoCA were lower in patients with fasting hyperhomocysteinemia and patients with hyperhomocysteinemia after MLT than in patients with normal fasting plasma Hcy at 7 d,14 d and 30 d after treatment (P＜0.01 or 0.05),while the scores had no significant differences among the three group on admission (P＞0.05).There were no significant differences in MMSE and MoCA scores between patients with fasting hyperhomocysteinemia and patients with hyperhomocysteinemia after MLT on admission,7 d,14 d and 30 d after treatment (P＞0.05).Conclusions Hcy may be an independent risk factor for VCI.The MLT can discover the dormant vascular risk factors for VCI,which offers a valuable detection method for early intervention and prevention in the clinical medicine.