Kadoglou Nikolaos P E, Fotiadis Grigorios, Lambadiari Vaia, Maratou Eirini, Dimitriadis George, Liapis Christos D
Department of Vascular Surgery, Medical School, University of Athens, Greece.
First Department of Internal Medicine, "Hippokratio" General Hospital of Thessaloniki, Greece.
Peptides. 2014 Jul;57:12-6. doi: 10.1016/j.peptides.2014.04.008. Epub 2014 Apr 24.
This study evaluated serum levels of novel adipokines in acute ischemic stroke (AIS) and their association with prognosis. We enrolled 168 patients with AIS and 58 stroke-free age- and sex-matched individuals (controls). Clinical parameters, carotid ultrasound, metabolic profile, vaspin, apelin, visfatin, and ghrelin were assayed. Stroke-patients were sampled at hospital admission and were prospectively followed-up (median 16 months) for the cardiovascular endpoint (cardiovascular death/stroke/myocardial infarction). At admission, stroke-patients appeared with higher levels of systolic blood pressure, hsCRP and worse metabolic profile (p<0.05), (p>0.05). Compared to controls, AIS group had significantly higher serum concentrations of visfatin (22.92±9.72ng/ml vs 16.56±7.82ng/ml, p=0.006) and lower of vaspin (0.94±0.43ng/ml vs 1.84±0.82ng/ml, p=0.019) and ghrelin (3.47±1.44ng/ml vs 5.93±2.78ng/ml, p<0.001), while apelin did not differ between groups. Similar differences in adipokines were found between stroke subgroups with and without significant ipsilateral carotid stenosis (>50%) (p<0.05). In stepwise logistic regression analysis adjusted for diabetes, hypertension, dyslipidemia and age, visfatin (p=0.026) and ghrelin (p=0.012) proved to be independent predictors of AIS. During follow-up, 27 patients achieved cardiovascular endpoint. In addition to coronary artery disease and NIHSS score, visfatin serum levels was associated with cardiovascular endpoint (HR: 1.255, 95% CI: 1.025-1.576). Our results suggested the association of AIS with higher visfatin and lower vaspin and ghrelin serum levels. Visfatin levels can be a predictor of cardiovascular mortality and morbidity in AIS.
本研究评估了急性缺血性卒中（AIS）患者血清中新型脂肪因子的水平及其与预后的关系。我们纳入了168例AIS患者和58例年龄及性别匹配的无卒中个体（对照组）。检测了临床参数、颈动脉超声、代谢指标、内脏脂肪素、脂联素、内脂素和胃饥饿素。卒中患者在入院时采样，并对心血管终点事件（心血管死亡/卒中/心肌梗死）进行前瞻性随访（中位时间16个月）。入院时，卒中患者的收缩压、高敏C反应蛋白水平较高，代谢指标较差（p<0.05），（p>0.05）。与对照组相比，AIS组血清内脂素浓度显著更高（22.92±9.72ng/ml对16.56±7.82ng/ml，p=0.006），而脂联素（0.94±0.43ng/ml对1.84±0.82ng/ml，p=0.019）和胃饥饿素（3.47±1.44ng/ml对5.93±2.78ng/ml，p<0.001）较低，而脂联素在两组间无差异。在有和无明显同侧颈动脉狭窄（>50%）的卒中亚组之间，脂肪因子也存在类似差异（p<0.05）。在对糖尿病、高血压、血脂异常和年龄进行校正的逐步逻辑回归分析中，内脏脂肪素（p=0.026）和胃饥饿素（p=0.012）被证明是AIS的独立预测因子。随访期间，27例患者发生心血管终点事件。除了冠状动脉疾病和美国国立卫生研究院卒中量表评分外，血清内脏脂肪素水平与心血管终点事件相关（HR：1.255，95%CI：1.025-1.576）。我们的结果提示AIS与较高的内脏脂肪素水平以及较低的脂联素和胃饥饿素血清水平有关。内脏脂肪素水平可能是AIS患者心血管死亡率和发病率的一个预测指标。
