更高的血清脂联素 2 与出院时的卒中后抑郁有关。
Higher serum lipocalin 2 is associated with post-stroke depression at discharge.
机构信息
Department of Neurology, Affiliated Huai'an Hospital of Xuzhou Medical University, No.62, South Huaihai Road, Huai'an 223002, Huai'an, 223002, Jiangsu, China.
出版信息
BMC Neurol. 2023 Aug 5;23(1):294. doi: 10.1186/s12883-023-03319-y.
BACKGROUND AND AIMS
Post-stroke depression (PSD), as one of the common complications after stroke, seriously affects the physical and mental health and functional prognosis of patients. Previous studies have shown that the increase of inflammatory mediators is associated with the occurrence of PSD. Lipocalin 2 (LCN2), as an acute phase protein, is involved in the development of acute ischemic stroke (AIS), and its expression is up-regulated in patients with depression, suggesting that there is a potential correlation between serum LCN2 and depression. The aim of this study was to explore the relationship between serum LCN2 at admission and PSD at discharge.
METHODS
A total of 358 AIS patients were retrospectively included. All patients had fasting venous blood taken within 24 h of admission to detect serum LCN2. The patients were evaluated by 17-item Hamilton Depression Scale (HAMD) before discharge. Patients with HAMD score > 7 were diagnosed with PSD. The correlation between serum LCN2 and PSD was tested using binary logistic regression analysis.
RESULTS
In our study, 92 (25.7%) patients were diagnosed with PSD at discharge. According to the serum LCN2 value, the patients were divided into three layers (Tertile1 ≤ 105.24ng/ml; Tertile2: 105.24-140.12ng/ml; Tertile3 ≥ 140.12ng/ml), with T1 layer (the lowest levels) as a reference, after adjusting for multiple potential confounding factors, T3 layer (the highest levels) was independently associated with the occurrence of PSD (odds ratio [OR] = 2.639, 95% confidence interval [CI]: 1.317-5.287, P = 0.006). Similar results were found when the serum LCN2 was analyzed as a continuous variable. The optimal cut-off value of serum LCN2 at admission to predict PSD at discharge was 117.60ng/ml, at this threshold, the sensitivity was 77.2%, and the specificity was 53.4%.
CONCLUSIONS
High serum LCN2 levels at admission are an independent risk factor for PSD in patients with AIS at discharge.
背景与目的
卒中后抑郁（PSD）是卒中后常见并发症之一，严重影响患者的身心健康和功能预后。既往研究表明，炎症介质的增加与 PSD 的发生有关。载脂蛋白 L2（LCN2）作为一种急性期蛋白，参与急性缺血性卒中（AIS）的发生，其在抑郁患者中的表达上调，提示血清 LCN2 与抑郁之间存在潜在相关性。本研究旨在探讨入院时血清 LCN2 与出院时 PSD 的关系。
方法
回顾性纳入 358 例 AIS 患者。所有患者入院 24 小时内空腹抽取静脉血检测血清 LCN2。患者在出院前采用汉密尔顿抑郁量表（HAMD）进行评估。HAMD 评分＞7 分者诊断为 PSD。采用二元逻辑回归分析检验血清 LCN2 与 PSD 的相关性。
结果
本研究中，92 例（25.7%）患者出院时诊断为 PSD。根据血清 LCN2 值将患者分为 3 层（Tertile1≤105.24ng/ml；Tertile2：105.24-140.12ng/ml；Tertile3≥140.12ng/ml），以 T1 层（最低水平）为参照，调整多个潜在混杂因素后，T3 层（最高水平）与 PSD 的发生独立相关（比值比[OR]＝2.639，95%置信区间[CI]：1.317-5.287，P＝0.006）。当连续变量分析血清 LCN2 时，也得到了相似的结果。入院时血清 LCN2 预测出院时 PSD 的最佳截断值为 117.60ng/ml，此时灵敏度为 77.2%，特异性为 53.4%。
结论
入院时血清 LCN2 水平升高是 AIS 患者出院时 PSD 的独立危险因素。
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