title: Predictive value of early decreased plasma ghrelin level for three-month cognitive deterioration in patients with mild traumatic brain injury.
abstract: The orexigenic hormone, ghrelin, is tightly linked to cognition impairment in neurodegenerative disorders. No previous studies have investigated the early ghrelin concentration change in patients with mild traumatic brain injury (mTBI) and it's relationship to cognitive deterioration. This study was performed to investigate the early plasma ghrelin concentrations in patients with mTBI and to explore the relationship between ghrelin and cognitive deterioration. Plasma ghrelin concentrations of 118 adults after acute mTBI were determined by enzyme-linked immunosorbent assay. Forty patients (33.9%) had cognitive deterioration three months after mTBI. Plasma ghrelin levels were significantly lower in mTBI patients with cognitive deterioration than patients without cognitive deterioration (38.8±4.5 pg/mL vs 50.8±7.7 pg/mL, P<0.001). Decreased Plasma ghrelin level was identified as an independent predictor for three-month cognitive deterioration after mTBI (odds ratio, 0.746; 95% confidence interval, 0.651-0.856; P<0.001). Plasma ghrelin level was negatively associated with serum adrenocorticotrophin hormone level (t=-6.854, P<0.001) and age (t=-6.112, P<0.001). A plasma ghrelin level of 41.6 pg/mL predicted three-month cognitive deterioration after mTBI with the optimal sensitivity (85.9%) and specificity (80.0%) values (area under curve, 0.904; 95% confidence interval, 0.852-0.957; P<0.001). The predictive value of ghrelin was bigger than that of serum adrenocorticotrophin hormone level (area under curve, 0.638; 95% confidence interval, 0.536-0.741; P=0.014) and age (area under curve, 0.638; 95% confidence interval, 0.536-0.741; P=0.014) for three-month cognitive deterioration after mTBI.
authors: Department of Neurosurgery, First Affiliated Hospital of Zhejiang Chinese Medicine University, 54 Youdian Lane, Hangzhou 310006, China. Electronic address: xuzhenhangzhou@yeah.net.
authors: Zhen
authors: Z
authors: Xu
authors: Department of Surgery, First Affiliated Hospital of Zhejiang Chinese Medicine University, 54 Youdian Lane, Hangzhou 310006, China.
authors: Xiao-Ai
authors: XA
authors: Lv
authors: Department of Neurosurgery, Affiliated Hospital of Hebei University, 212 Yuhua East Lane, Baoding 071000, China.
authors: Ji-Wei
authors: JW
authors: Wang
authors: Department of Neurosurgery, First Affiliated Hospital of Zhejiang Chinese Medicine University, 54 Youdian Lane, Hangzhou 310006, China.
authors: Zu-Peng
authors: ZP
authors: Chen
authors: Department of Surgery, First Affiliated Hospital of Zhejiang Chinese Medicine University, 54 Youdian Lane, Hangzhou 310006, China.
authors: Hua-Sen
authors: HS
authors: Qiu
mesh_terms: D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000367:Age Factors; D001930:Brain Injuries / Q000097:blood* / Q000503:physiopathology / Q000523:psychology; D002648:Child; D003071:Cognition; D003072:Cognition Disorders / Q000097:blood; D016001:Confidence Intervals; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D055815:Young Adult
chemical_list: D054439:Ghrelin; D000324:Adrenocorticotropic Hormone
keywords: Cognitive deterioration; Ghrelin; Mild traumatic brain injury