title: The effect of insulin resistance on inflammatory response and oxidative stress in acute cerebral ischemia.
abstract: OBJECTIVE
  Insulin resistance (IR) has effects on inflammation and oxidative stress which have importance in acute stroke. Our aim was to investigate the relationships between IR, inflammation, oxidative stress and stroke severity in acute ischemic stroke patients.
  
  
  METHODS
  We examined the relationships between inflammation, oxidative stress and stroke severity in 75 acute stroke patients with and without IR. Serum levels of oxidative stress markers (nitric oxide (NO), malondialdehyde (MDA), glutathione (GSH)) were measured as well as the cytokines interleukin-6 (IL-6) and interleukin-10 (IL-10).
  
  
  RESULTS
  The levels of IL-10 (13.7±19.11 vs 51.20±89.32 pg/ml, p<0.00) in IR group were significantly reduced. Patients with IR had higher levels of NO (30.26±17.63 vs 22.57±14.5 µmol/L, p=0.04) and IL6 (27.44±57.13 vs 8.68±11.8 pg/ml, p<0.00) and higher NIHSS scores (11.40±5.35 vs 8.81±5.76, p=0.04) when compared with noninsulin resistant group. IL-10 was found negatively correlated with HOMA. Additionally, the parameters with positive correlations with HOMA were NIHSS, IL-6 and NO.
  
  
  CONCLUSIONS
  Inflammation and oxidative stress are more evident in acute stoke patients with insulin resistance which may cause worse stroke severity. Our data also suggest that IL-10 as an antiinflammatory cytokine can be much lower in insulin resistance in acute phase of ischemic stroke. However it can be elevated as an adaptive mechanism in metabolic syndrome as a chronic condition.
authors.affiliation: Department of Neurology, Adnan Menderes University, Turkey. ozkulayca@hotmail.com
authors.forename: Ayca
authors.initials: A
authors.lastname: Ozkul
authors.forename: Mediha
authors.initials: M
authors.lastname: Ayhan
authors.forename: Ali
authors.initials: A
authors.lastname: Akyol
authors.forename: Eylem Telli
authors.initials: ET
authors.lastname: Turgut
authors.forename: Gurhan
authors.initials: G
authors.lastname: Kadikoylu
authors.forename: Cigdem
authors.initials: C
authors.lastname: Yenisey
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000276:immunology* / Q000378:metabolism*; D005260:Female; D005978:Glutathione / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000276:immunology* / Q000378:metabolism*; D007333:Insulin Resistance / Q000276:immunology*; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D018384:Oxidative Stress / Q000276:immunology*; D012720:Severity of Illness Index; D020521:Stroke / Q000276:immunology / Q000378:metabolism
chemical_list: C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D016753:Interleukin-10; D009569:Nitric Oxide; D008315:Malondialdehyde; D005978:Glutathione