Shan Wanying, Zhao Jie, Qiu Chunfang, Xu Guoli, Feng Jie
Department of Neurology, Suzhou Ninth People's Hospital, Soochow University, Suzhou, Jiangsu, 215200, People's Republic of China.
Department of Gerontology, Suzhou Ninth People's Hospital, Soochow University, Suzhou, Jiangsu, 215200, People's Republic of China.
Neuropsychiatr Dis Treat. 2023 Oct 18;19:2171-2178. doi: 10.2147/NDT.S435006. eCollection 2023.
Increased glial fibrillary acidic protein (GFAP) levels were found in cerebrovascular disease patients. The pathogenesis of depression after ischemic stroke remains largely unknown. Here, we aim to determine whether GFAP concentrations were associated with post-stroke depression (PSD) at 3 months.
From March 2022 to September 2022, patients with first-ever ischemic stroke were prospectively recruited. GFAP concentrations were detected within 24 h using an enzyme-linked immunosorbent assay. The PSD was defined as a Hamilton Depression Rating Scale 24-Item score ≥ 8.
A total of 206 subjects with ischemic stroke (mean age: 63.6 years; 49.0% female) were enrolled. During the 90-day follow-up, 57 participants (27.7%) were observed in PSD. The median serum GFAP concentrations were 0.67 ng/mL. After adjustment for the covariates, higher increased GFAP levels were associated with increased risk of PSD (odds ratio [OR], 7.12; 95% confidence interval [CI], 3.29-15.44; < 0.001). Also, the multivariate-adjusted OR of PSD associated with the fourth quartile of GFAP was 10.89 (95% CI, 3.53-33.60; < 0.001) compared with the first quartile. Furthermore, the restricted cubic spline confirmed a linear association between GFAP and the risk of PSD ( for linearity < 0.001).
Our results indicated that increased circulating GFAP concentrations were significantly correlated with the risk of PSD at 3 months. Measuring the GFAP levels after ischemic stroke may add some values for the risk stratifying of PSD.
脑血管疾病患者的胶质纤维酸性蛋白(GFAP)水平升高。缺血性卒中后抑郁症的发病机制在很大程度上仍不清楚。在此,我们旨在确定GFAP浓度是否与3个月时的卒中后抑郁症(PSD)相关。
2022年3月至2022年9月,前瞻性招募首次发生缺血性卒中的患者。使用酶联免疫吸附测定法在24小时内检测GFAP浓度。PSD定义为汉密尔顿抑郁量表24项评分≥8分。
共纳入206例缺血性卒中患者(平均年龄:63.6岁;49.0%为女性)。在90天的随访期间,观察到57名参与者(27.7%)患有PSD。血清GFAP浓度中位数为0.67 ng/mL。在对协变量进行调整后,GFAP水平升高与PSD风险增加相关(比值比[OR],7.12;95%置信区间[CI],3.29 - 15.44;P < 0.001)。此外,与第一四分位数相比,与GFAP第四四分位数相关的PSD多变量调整OR为10.89(95% CI,3.53 - 33.60;P < 0.001)。此外,受限立方样条证实了GFAP与PSD风险之间存在线性关联(线性检验P < 0.001)。
我们的结果表明,循环GFAP浓度升高与3个月时的PSD风险显著相关。测量缺血性卒中后的GFAP水平可能为PSD的风险分层增加一些价值。