Kirchberger Inge, Meisinger Christa, Freuer Dennis, Leone Vincenza, Ertl Michael, Zickler Philipp, Naumann Markus, Linseisen Jakob
Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany.
Front Neurol. 2023 Jan 23;13:1075383. doi: 10.3389/fneur.2022.1075383. eCollection 2022.
Chronic fatigue is a common symptom after a stroke. Studies suggested that chronic fatigue is caused by inflammatory or immunological processes but data are limited and contradictory. Thus, the present study aimed to identify specific biomarkers associated with fatigue in post-stroke patients and replicated the findings in a population-based study.
We investigated associations between 39 circulating biomarkers of inflammation and fatigue in 327 patients after an ischemic stroke included in the Stroke Cohort Augsburg (SCHANA) study and the "Metabolism, Nutrition and Immune System in Augsburg" (MEIA) study ( = 140). The Fatigue Assessment Scale (FAS) was used to assess the severity of fatigue. The serum concentrations of the biomarkers were measured using the Bio-Plex Pro™ Human Cytokine Screening Panel (Bio-Rad, USA). Multiple linear regression models adjusted for possible confounders were used to examine associations.
In patients with stroke, SCGFb was inversely associated [-1.67, 95% confidence interval (CI) (-3.05; -0.29) = 0.018], and in healthy subjects, G-CSF was positively associated [1.56, 95% CI (0.26; 2.87), = 0.020] with an increasing FAS-score, while SCF was positively related in both samples [1.84, 95% CI (0.27; 3.42), = 0.022 and 1.40, 95% CI (0.29; 2.52), = 0.015]. However, after correction for multiple testing, all of these associations lost statistical significance.
The present findings suggested an association between the growth factor SCF and fatigue. Future research on cytokines as possible markers of fatigue should focus on a longitudinal design including a sufficiently large number of study participants to enable testing associations between certain cytokines and sub-groups of chronic fatigue.
慢性疲劳是中风后的常见症状。研究表明,慢性疲劳是由炎症或免疫过程引起的,但数据有限且相互矛盾。因此,本研究旨在确定与中风后患者疲劳相关的特定生物标志物,并在一项基于人群的研究中重复这些发现。
我们在奥格斯堡中风队列(SCHANA)研究和“奥格斯堡的代谢、营养与免疫系统”(MEIA)研究(n = 140)中,调查了327例缺血性中风患者中39种循环炎症生物标志物与疲劳之间的关联。使用疲劳评估量表(FAS)评估疲劳的严重程度。使用Bio-Plex Pro™人细胞因子筛选试剂盒(美国伯乐公司)测量生物标志物的血清浓度。采用针对可能混杂因素进行调整的多元线性回归模型来检验关联。
在中风患者中,干细胞生长因子b(SCGFb)与疲劳呈负相关[-1.67,95%置信区间(CI)(-3.05;-0.29),P = 0.018],而在健康受试者中,粒细胞集落刺激因子(G-CSF)与疲劳呈正相关[1.56,95%CI(0.26;2.87),P = 0.020],随着FAS评分升高,而干细胞因子(SCF)在两个样本中均与疲劳呈正相关[1.84,95%CI(0.27;3.42),P = 0.022和1.40,95%CI(0.29;2.52),P = 0.015]。然而,在进行多重检验校正后,所有这些关联均失去统计学意义。
本研究结果提示生长因子SCF与疲劳之间存在关联。未来关于细胞因子作为疲劳可能标志物的研究应侧重于纵向设计,包括足够多的研究参与者,以检验某些细胞因子与慢性疲劳亚组之间的关联。