Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
J Affect Disord. 2017 Oct 1;220:95-101. doi: 10.1016/j.jad.2017.05.023. Epub 2017 May 10.
There is evidence that stroke is accompanied by oxidative stress. However, the links between oxidative stress and depression in stroke patients are poorly understood. This study examines whether post-stroke depression (PSD) is associated with oxidative stress.
Overall, 216 acute stroke patients were consecutively recruited and followed up for 1 month. Blood specimens were collected within 24h after admission and measured for the following oxidative stress biomarkers: malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX). All enrolled patients were divided into the PSD group or the non-PSD group according to an assessment of clinical depression. One hundred normal control subjects were also recruited.
There was a positive correlation between serum MDA levels and HAMD scores in stroke patients (r=0.536, p<0.001). Based on the Receiver-operating characteristic (ROC) curve, the optimal cutoff value of serum MDA levels as an indicator for an auxiliary diagnosis of PSD was projected to be 2.898 nmol/ml, which yielded a sensitivity of 77.9% and a specificity of 81.1%, with an area under the curve of 0.883 (95% CI, 0.836-0.929). Elevated MDA (≥2.898 nmol/ml) was an independent predictive marker of PSD (odds ratio OR=24.295; 95% CI, 9.461-62.388; p<0.001, adjusted for relevant confounders).
We excluded patients with severe aphasia or with serious conditions. In addition, the information for dietary intake was not recorded, which may influence oxidative stress levels.
Our study demonstrated that an elevated serum MDA level at admission was positively associated with an increased risk of developing depression after acute stroke, especially minor stroke.
有证据表明，中风伴随着氧化应激。然而，中风患者的氧化应激与抑郁之间的联系还不清楚。本研究旨在探讨中风后抑郁（PSD）是否与氧化应激有关。
共连续招募了 216 名急性中风患者，并在发病后 1 个月进行随访。入院后 24 小时内采集血样，检测以下氧化应激生物标志物：丙二醛（MDA）、超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶（GSH-PX）。根据临床抑郁评估，将所有入组患者分为 PSD 组和非 PSD 组。还招募了 100 名正常对照者。
中风患者血清 MDA 水平与 HAMD 评分呈正相关（r=0.536，p<0.001）。根据受试者工作特征（ROC）曲线，血清 MDA 水平作为 PSD 辅助诊断指标的最佳截断值预测为 2.898 nmol/ml，其敏感性为 77.9%，特异性为 81.1%，曲线下面积为 0.883（95%置信区间，0.836-0.929）。MDA 升高（≥2.898 nmol/ml）是 PSD 的独立预测标志物（比值比 OR=24.295；95%置信区间，9.461-62.388；p<0.001，调整了相关混杂因素）。
我们排除了严重失语症或病情严重的患者。此外，未记录饮食摄入信息，这可能会影响氧化应激水平。
本研究表明，入院时血清 MDA 水平升高与急性中风后发生抑郁的风险增加（尤其是轻度中风）呈正相关。
