血浆脂联素对缺血性卒中的诊断、神经严重程度和功能结局的意义——缺血性卒中生物标志物研究（REBIOS）。

Significance of plasma adiponectin for diagnosis, neurological severity and functional outcome in ischemic stroke - Research for Biomarkers in Ischemic Stroke (REBIOS).

机构信息

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Cerebrovascular Medicine and Neurology, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka.

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka.

出版信息

Metabolism. 2014 Sep;63(9):1093-103. doi: 10.1016/j.metabol.2014.04.012. Epub 2014 May 2.

DOI:10.1016/j.metabol.2014.04.012

PMID:24929894

Abstract

OBJECTIVE

Although adiponectin is a major adipocytokine that affects the pathogenesis of various cardiovascular diseases, its clinical significance in stroke remains controversial. We investigated the clinical significance of plasma adiponectin for the diagnosis, neurological severity and functional outcomes of patients with ischemic stroke.

METHODS

We prospectively enrolled 171 patients with ischemic stroke and 171 age- and sex-matched healthy controls. Blood samples and clinical information were obtained at day 0, 3, 7, 14 and 90 after stroke onset.

RESULTS

Average adiponectin values at day 0 did not significantly differ between the controls and the patients, but were significantly lower and higher in patients with atherothrombotic brain (ATBI) (p=0.047) and cardioembolic (CE) (p=0.008) infarction, respectively, than in the controls. Multivariate logistic regression analyses showed that the adiponectin value at day 0 could predict ATBI (odds ratio, 0.75; 95% confidence interval, 0.58 to 0.91, p=0.009, per 1-μg/mL increase). Adiponectin values at day 0 were positively associated with neurological severity as evaluated by the National Institute of Health Stroke Scale upon admission (r=0.420, p=0.003) and were higher in the groups with poor outcomes (modified Rankin Scale (mRS) ≥ 3 on day 90) than in those with good ones (mRS ≤ 2) in all stroke subtypes, with statistical significance in ATBI (p=0.015).

CONCLUSIONS

Plasma adiponectin values may help to classify stroke subtypes and predict neurological severity and functional outcome in ischemic stroke patients.

摘要

目的

虽然脂联素是一种主要的脂肪细胞因子，影响各种心血管疾病的发病机制，但它在中风中的临床意义仍存在争议。我们研究了血浆脂联素对缺血性中风患者的诊断、神经严重程度和功能结局的临床意义。

方法

我们前瞻性纳入了 171 例缺血性中风患者和 171 名年龄和性别匹配的健康对照者。在中风发病后第 0、3、7、14 和 90 天采集血样和临床资料。

结果

对照组和患者组在第 0 天的平均脂联素值没有显著差异，但在动脉粥样硬化血栓性脑梗死（ATBI）（p=0.047）和心源性栓塞（CE）（p=0.008）患者中分别显著低于和高于对照组。多变量逻辑回归分析显示，第 0 天的脂联素值可以预测 ATBI（比值比，0.75；95%置信区间，0.58 至 0.91，p=0.009，每增加 1μg/mL）。第 0 天的脂联素值与入院时国立卫生研究院中风量表评估的神经严重程度呈正相关（r=0.420，p=0.003），在所有中风亚型中，预后不良（90 天改良 Rankin 量表（mRS）≥3）组的脂联素值均高于预后良好（mRS≤2）组，在 ATBI 中具有统计学意义（p=0.015）。