Muscle quality index combined with plasma metabolomics: enhancing risk stratification for post-stroke dementia.
- 1Department of Cardiology, Suining Central Hospital, Suining, Sichuan, China.
- 2Department of Ultrasound Medicine, Suining Central Hospital, Suining, Sichuan, China.
- 3Department of Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Abstract
Objective
Post-stroke dementia is a severe long-term stroke complication with heavy medical burdens, and early risk identification is critical. This study explored the association of muscle quality index (MQI) and plasma metabolomics with dementia among stroke survivors.Methods
This study included 7,047 UK Biobank participants with a history of stroke who were free of dementia at the baseline assessment. MQI was defined as dominant handgrip strength (HGS) divided by corresponding arm fat-free mass. Plasma metabolomics was analyzed via high-throughput nuclear magnetic resonance (NMR). Metabolomics risk scores (MRS-ACD, MRS-AD, and MRS-VaD) were constructed using metabolite features screening with LASSO regression and XGBoost algorithms. Statistical analyses included Cox proportional hazards models, time-dependent receiver operating characteristic (TD-ROC), restricted cubic spline (RCS) regression, interaction analyses, Mendelian randomization (MR), and several sensitivity analyses.Results
Higher MQI was associated with lower risks of all-cause dementia (ACD), Alzheimer's disease (AD) and vascular dementia (VaD) (all p for trend <0.05). Each 1-SD increment in MRS was associated with a higher risk of ACD (HR = 1.63, 95% CI: 1.36-1.96), AD (HR = 2.40, 95% CI: 1.74-3.31), and VaD (HR = 1.92, 95% CI: 1.46-2.54). Individuals with high MRS and lowest MQI had the highest ACD (HR = 3.29, 95% CI: 1.91-5.68), AD (HR = 5.83, 95% CI: 1.75-19.37), and VaD (HR = 4.57, 95% CI: 2.28-9.14) risk. MQI was linearly negatively associated with ACD (p for non-linear = 0.240) and VaD (p for non-linear = 0.665), and non-linearly associated with AD (p for non-linear = 0.013). Two-sample MR using genetically proxied grip strength and lean mass provided suggestive genetic evidence for muscle-dementia relationships: higher genetically predicted lean mass reduced AD risk (OR = 0.92, 95% CI 0.86-0.99, p = 0.027), while grip strength showed an independent protective effect on VaD after accounting for lean mass (OR = 0.16, 95% CI 0.04-0.64, p = 0.009). Extensive sensitivity analyses confirmed the robustness of the main findings.Conclusion
Joint assessment of MQI and plasma metabolomics provides suggestive evidence for stratifying post-stroke dementia risk and may assist early risk screening in stroke survivors.
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BibTeX
@article{tan2026muscle,
title = {{Muscle quality index combined with plasma metabolomics: enhancing risk stratification for post-stroke dementia.}},
author = {Zhen Tan and Shuang Li and Tianjiao Li and Lei Liu and Xinrui Xue and Xiaoping Li and Hongqiang Ren},
journal = {Frontiers in aging neuroscience},
year = {2026},
month = sep,
doi = {10.3389/fnagi.2026.1837030},
url = {https://europepmc.org/article/MED/42871063},
note = {CC BY},
}
RIS
TY - JOUR
TI - Muscle quality index combined with plasma metabolomics: enhancing risk stratification for post-stroke dementia.
AU - Zhen Tan
AU - Shuang Li
AU - Tianjiao Li
AU - Lei Liu
AU - Xinrui Xue
AU - Xiaoping Li
AU - Hongqiang Ren
PY - 2026
DA - 2026/09/29
JO - Frontiers in aging neuroscience
DO - 10.3389/fnagi.2026.1837030
UR - https://europepmc.org/article/MED/42871063
AB - Objective Post-stroke dementia is a severe long-term stroke complication with heavy medical burdens, and early risk identification is critical. This study explored the association of muscle quality index (MQI) and plasma metabolomics with dementia among stroke survivors.Methods This study included 7,047 UK Biobank participants with a history of stroke who were free of dementia at the baseline assessment. MQI was defined as dominant handgrip strength (HGS) divided by corresponding arm fat-free mass. Plasma metabolomics was analyzed via high-throughput nuclear magnetic resonance (NMR). Metabolomics risk scores (MRS-ACD, MRS-AD, and MRS-VaD) were constructed using metabolite features screening with LASSO regression and XGBoost algorithms. Statistical analyses included Cox proportional hazards models, time-dependent receiver operating characteristic (TD-ROC), restricted cubic spline (RCS) regression, interaction analyses, Mendelian randomization (MR), and several sensitivity analyses.Results Higher MQI was associated with lower risks of all-cause dementia (ACD), Alzheimer's disease (AD) and vascular dementia (VaD) (all p for trend <0.05). Each 1-SD increment in MRS was associated with a higher risk of ACD (HR = 1.63, 95% CI: 1.36-1.96), AD (HR = 2.40, 95% CI: 1.74-3.31), and VaD (HR = 1.92, 95% CI: 1.46-2.54). Individuals with high MRS and lowest MQI had the highest ACD (HR = 3.29, 95% CI: 1.91-5.68), AD (HR = 5.83, 95% CI: 1.75-19.37), and VaD (HR = 4.57, 95% CI: 2.28-9.14) risk. MQI was linearly negatively associated with ACD (p for non-linear = 0.240) and VaD (p for non-linear = 0.665), and non-linearly associated with AD (p for non-linear = 0.013). Two-sample MR using genetically proxied grip strength and lean mass provided suggestive genetic evidence for muscle-dementia relationships: higher genetically predicted lean mass reduced AD risk (OR = 0.92, 95% CI 0.86-0.99, p = 0.027), while grip strength showed an independent protective effect on VaD after accounting for lean mass (OR = 0.16, 95% CI 0.04-0.64, p = 0.009). Extensive sensitivity analyses confirmed the robustness of the main findings.Conclusion Joint assessment of MQI and plasma metabolomics provides suggestive evidence for stratifying post-stroke dementia risk and may assist early risk screening in stroke survivors.
SN - 1663-4365
ER -