Objective: To explore the relationship between metabolic syndrome (MetS) and cognitive impairment in elderly patients with white matter lesions (WML). Methods: From -January 2016 to June 2017, a cross-sectional study was conducted on the clinical data of 358 WML patients over 65 years old in the Department of Neurology of the Daping Hospital. Mini-mental state examination scales were used to evaluate the cognitive function of the patients, and the cognitive impairment was diagnosed and grouped according to the scoring and diagnostic criteria. All WML patients were divided into the cognitive impairment group and normal cognition group. Clinical data of age, sex, education level, body mass index, abdominal circumference, smoking and alcohol consumption, blood pressure, fasting blood glucose, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) were collected. Multivariate logistic regression analyses were performed to examine the relationship between MetS and cognitive impairment in WML patients. Results: Compared with the normal cognition group, the proportion of MetS in the cognitive impairment group was significantly higher (χ2 = 11.211, p < 0.01), the proportion of MetS components such as elevated blood pressure, elevated blood glucose, elevated TG, decreased HDL-C and abdominal obesity in the cognitive impairment group was also higher (p < 0.01 or p < 0.05). After adjustment for age, sex, low education level, current smoking, daily drinking, severity of WML, MetS, and its components, multivariate logistic regression analysis showed that MetS was an independent risk factor for cognitive impairment in WML patients (OR 3.32, 95% CI 1.31–5.19). In addition, The greater the number of MetS components, the higher the risk of cognitive impairment in WML patients (ptrend < 0.01). Conclusion: MetS is an independent risk factor for cognitive impairment in patients with WML.

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