Serum levels of novel adipokines in patients with acute ischemic stroke: potential contribution to diagnosis and prognosis.
This study evaluated serum levels of novel adipokines in acute ischemic stroke (AIS) and their association with prognosis. We enrolled 168 patients with AIS and 58 stroke-free age- and sex-matched individuals (controls). Clinical parameters, carotid ultrasound, metabolic profile, vaspin, apelin, visfatin, and ghrelin were assayed. Stroke-patients were sampled at hospital admission and were prospectively followed-up (median 16 months) for the cardiovascular endpoint (cardiovascular death/stroke/myocardial infarction). At admission, stroke-patients appeared with higher levels of systolic blood pressure, hsCRP and worse metabolic profile (p<0.05), (p>0.05). Compared to controls, AIS group had significantly higher serum concentrations of visfatin (22.92±9.72ng/ml vs 16.56±7.82ng/ml, p=0.006) and lower of vaspin (0.94±0.43ng/ml vs 1.84±0.82ng/ml, p=0.019) and ghrelin (3.47±1.44ng/ml vs 5.93±2.78ng/ml, p<0.001), while apelin did not differ between groups. Similar differences in adipokines were found between stroke subgroups with and without significant ipsilateral carotid stenosis (>50%) (p<0.05). In stepwise logistic regression analysis adjusted for diabetes, hypertension, dyslipidemia and age, visfatin (p=0.026) and ghrelin (p=0.012) proved to be independent predictors of AIS. During follow-up, 27 patients achieved cardiovascular endpoint. In addition to coronary artery disease and NIHSS score, visfatin serum levels was associated with cardiovascular endpoint (HR: 1.255, 95% CI: 1.025-1.576). Our results suggested the association of AIS with higher visfatin and lower vaspin and ghrelin serum levels. Visfatin levels can be a predictor of cardiovascular mortality and morbidity in AIS.
Department of Vascular Surgery, Medical School, University of Athens, Greece. Electronic address: nikoskad@yahoo.com.
Nikolaos P E
NP
Kadoglou
First Department of Internal Medicine, "Hippokratio" General Hospital of Thessaloniki, Greece.
Grigorios
G
Fotiadis
2(nd) Department of Internal Medicine, Research Institute and Diabetes Centre, Attikon University hospital, Athens University Medical School, Athens, Greece.
Vaia
V
Lambadiari
2(nd) Department of Internal Medicine, Research Institute and Diabetes Centre, Attikon University hospital, Athens University Medical School, Athens, Greece.
Eirini
E
Maratou
2(nd) Department of Internal Medicine, Research Institute and Diabetes Centre, Attikon University hospital, Athens University Medical School, Athens, Greece.
George
G
Dimitriadis
Department of Vascular Surgery, Medical School, University of Athens, Greece.
Christos D
CD
Liapis
D000368:Aged; D000073861:Apelin; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D015843:Serpins / Q000097:blood*; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000401:mortality
C115436:APLN protein, human; D000073861:Apelin; D054439:Ghrelin; D036341:Intercellular Signaling Peptides and Proteins; C507339:SERPINA12 protein, human; D015843:Serpins; D054409:Nicotinamide Phosphoribosyltransferase
Acute ischemic stroke; Adipokines; Apelin; Ghrelin; Vaspin; Visfatin