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缺血性脑卒中患者血清脂联素水平降低与卒中后抑郁风险

Reduced Serum Adiponectin Level and Risk of Poststroke Depression in Patients with Ischemic Stroke.

作者信息

Yang Junhua, Du Guanghui, Wang Jinyu, Chen Jia, Yang Chenghui, Li Jia, Zhang Yun

机构信息

Center of Psychosomatic Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.

University of Electronic Science and Technology of China, Chengdu, China.

出版信息

J Stroke Cerebrovasc Dis. 2019 Feb;28(2):305-310. doi: 10.1016/j.jstrokecerebrovasdis.2018.09.057. Epub 2018 Nov 2.

Abstract

BACKGROUND AND AIMS

Decreased adiponectin (APN) level has been indicated to be associated with depression. In the present study, we aimed to investigate whether serum APN could predict poststroke depression (PSD) at 3 months in patients with acute ischemic stroke.

METHOD

Patients with first-ever ischemic stroke and hospitalized within 24 hours of symptoms onset were enrolled prospectively during March 2017 to September 2017. Serum APN level was measured at admission by enzyme-linked immunosorbent assay. Neuropsychological evaluations were performed at the 3-month follow-up. PSD was diagnosed using the Chinese version of the Structured Clinical Interview for DSM-IV. The association between APN level and predict PSD was analyzed by binary logistic regression analysis.

RESULTS

Of the 255 acute ischemic stroke patients included, the median (interquartile range) APN level was 5.4 (3.0-7.5) μg/mL. PSD was observed in 69 patients, which accounted for 27.1% (95% confidence interval, 24.3%-29.9%) of the cohort. Patients with PSD showed lower level of APN (3.5 [2.5-6.3] μg/mL versus 6.2 [3.5-8.0] μg/mL, P = .001) at admission. Univariate logistic regression analysis indicated that patients with APN level in the first tertile compared with the third tertile were more likely to have PSD (odds ratio, 3.550; 95% confidence interval, 1.732-7.276; P = .008). The association remained significant even after multivariable adjustment for potential confounders.

CONCLUSIONS

This study demonstrated that decreased APN level at admission might be associated with PSD in patients after acute ischemic stroke.

摘要

背景与目的

已有研究表明脂联素(APN)水平降低与抑郁症有关。在本研究中,我们旨在调查血清APN是否能够预测急性缺血性脑卒中患者3个月时的卒中后抑郁(PSD)。

方法

前瞻性纳入2017年3月至2017年9月期间首次发生缺血性脑卒中且在症状发作24小时内入院的患者。入院时采用酶联免疫吸附测定法测量血清APN水平。在3个月随访时进行神经心理学评估。使用中文版《精神疾病诊断与统计手册第四版》的结构化临床访谈来诊断PSD。通过二元逻辑回归分析APN水平与预测PSD之间的关联。

结果

纳入的255例急性缺血性脑卒中患者中,APN水平的中位数(四分位间距)为5.4(3.0 - 7.5)μg/mL。69例患者出现PSD,占队列的27.1%(95%置信区间,24.3% - 29.9%)。PSD患者入院时的APN水平较低(3.5 [2.5 - 6.3] μg/mL对6.2 [3.5 - 8.0] μg/mL,P = 0.001)。单因素逻辑回归分析表明,与第三分位数相比,APN水平处于第一分位数的患者更有可能发生PSD(比值比,3.550;95%置信区间,1.732 - 7.276;P = 0.008)。即使在对潜在混杂因素进行多变量调整后,该关联仍然显著。

结论

本研究表明,急性缺血性脑卒中患者入院时APN水平降低可能与PSD有关。

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