Department of Neurology and Clinical Research Center for Stroke, Seoul National University Hospital, Seoul, Republic of Korea.
J Neurol Sci. 2012 Jan 15;312(1-2):117-22. doi: 10.1016/j.jns.2011.08.007. Epub 2011 Aug 24.
Experimental studies have indicated that adipocytokines are associated with vascular diseases with regard to the pathology of atherosclerotic plaque. We hypothesized that the strength of the associations between adipocytokines and stroke would differ between ischemic stroke subtypes.
A total of 96 acute ischemic stroke patients (within 5 days from onset) and 48 non-stroke subjects were analyzed in this study. Stroke patients were comprised of 26 strokes due to large artery atherosclerosis (LAA) and 72 non-LAA strokes. Venous blood from all participants was drawn after an overnight fast, and serum levels of leptin, adiponectin and resistin were measured by multiple sandwich immunoassay techniques.
Compared with non-LAA strokes, patients with LAA strokes had lower levels of serum adiponectin (6.4 ± 3.1 vs. 8.5 ± 3.9 μg/mL; P=0.04), and a higher level of leptin-to-adiponectin ratio (L:A ratio; 1.6 ± 1.4 vs. 0.9 ± 0.9; P<0.01). Multinomial logistic regression analyses showed that, although none of the adipocytokines was associated with non-LAA strokes, lower adiponectin (adjusted OR, 0.79 per 1-μg/mL increase; 95% CI, 0.64-0.98), higher leptin (aOR, 1.12 per 1-ng/mL increase; 95% CI, 1.004-1.25) and higher L:A ratio (aOR, 2.93 per 1-quartile increase; 95% CI, 1.39-6.15) showed significant associations with increased odds of having LAA stroke, compared to non-stroke subjects.
From our study, we documented that leptin and adiponectin had differential association patterns with ischemic stroke according to the stroke subtype. Careful consideration of the heterogeneity of stroke subtypes would be warranted in studying the utility of biomarkers including adipocytokines.
实验研究表明,脂肪细胞因子与血管疾病相关,尤其是与动脉粥样硬化斑块的病理学相关。我们假设,脂肪细胞因子与中风之间的关联强度在缺血性中风亚型之间会有所不同。
本研究共分析了 96 例急性缺血性中风患者(发病后 5 天内)和 48 例非中风患者。中风患者包括 26 例大动脉粥样硬化性中风(LAA)和 72 例非-LAA 中风。所有参与者在禁食一夜后抽取静脉血,采用多夹心免疫测定技术测量瘦素、脂联素和抵抗素的血清水平。
与非-LAA 中风相比,LAA 中风患者的血清脂联素水平较低(6.4 ± 3.1 与 8.5 ± 3.9 μg/ml;P=0.04),瘦素/脂联素比值较高(1.6 ± 1.4 与 0.9 ± 0.9;P<0.01)。多项逻辑回归分析表明,尽管脂肪细胞因子均与非-LAA 中风无关,但较低的脂联素(调整后的 OR,每增加 1μg/ml 降低 0.79;95%CI,0.64-0.98)、较高的瘦素(aOR,每增加 1ng/ml 增加 1.12;95%CI,1.004-1.25)和较高的 L:A 比值(aOR,每增加一个四分位数增加 2.93;95%CI,1.39-6.15)与 LAA 中风的几率增加显著相关,而非与非中风患者相关。
从我们的研究中可以看出,瘦素和脂联素与缺血性中风的关联模式根据中风亚型而不同。在研究包括脂肪细胞因子在内的生物标志物的实用性时,需要仔细考虑中风亚型的异质性。