title: Elevated Serum Levels of Neopterin at Admission Predicts Depression After Acute Ischemic Stroke: a 6-Month Follow-Up Study.
abstract: Inflammation and cell-mediated immune activation are attributed to the pathogenesis and pathophysiology in depression. Our aim was to test the possible association between serum levels of neopterin and the development of post-stroke depression (PSD) in Chinese patients. The subjects were first-ever acute ischemic stroke patients who were hospitalized at the First Affiliated Hospital of Xinxiang Medical University during the period from December 2012 to December 2013. Clinical information and stroke severity were collected at admission. Neurological and neuropsychological evaluations were conducted at the 6-month follow-up. Serum neopterin levels were measured using fluorometry and a high performance liquid chromatography (HPLC) method. Multivariate analyses were performed using logistic regression models. During the study period, 226 patients were included and finished the 6-month follow-up. Sixty-nine patients (30.5 %) were diagnosed as having major depression at 6 months. Patients with major depression showed higher levels of serum neopterin (21.6[IQR, 18.9-25.7]nmol/L vs. 14.6[IQR, 12.2-18.4]nmol/L, P < 0.0001) at admission. In multivariate analyses, serum neopterin was an independent predictor of PSD at 6 months [odds ratio (OR): 1.952 (95 % CI, 1.358-2.805), P < 0.0001]. With an AUC of 0.850 (95 % CI, 0.797-0.902), neopterin showed a significantly greater discriminatory ability as compared with high-sensitivity C-reactive protein, age, body mass index, and National Institutes of Health and Stroke Scale score. Neopterin is a novel, independent predictor of the development of depression 6 months after stroke. This indicated that the elevated neopterin levels may play a significant role in the pathology of depression and that the pathways leading to inflammation and cell-mediated immune activation warrant further exploration.
authors.affiliation: Laboratory of Molecular Medicine, College of Life Science, Henan Normal University, No. 46, Jianshedong Road, Xinxiang, Henan Province, 453007, China.
authors.forename: Chao-Zhi
authors.initials: CZ
authors.lastname: Tang
authors.affiliation: Laboratory of Molecular Medicine, College of Life Science, Henan Normal University, No. 46, Jianshedong Road, Xinxiang, Henan Province, 453007, China.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Zhang
authors.affiliation: Laboratory of Molecular Medicine, College of Life Science, Henan Normal University, No. 46, Jianshedong Road, Xinxiang, Henan Province, 453007, China. 041128@htu.cn.
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Wang
authors.affiliation: Laboratory of Molecular Medicine, College of Life Science, Henan Normal University, No. 46, Jianshedong Road, Xinxiang, Henan Province, 453007, China.
authors.forename: Wei-Guo
authors.initials: WG
authors.lastname: Li
authors.affiliation: The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China.
authors.forename: Ji-Peng
authors.initials: JP
authors.lastname: Shi
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications*; D003863:Depression / Q000097:blood* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019798:Neopterin / Q000097:blood*; D012372:ROC Curve; D020521:Stroke / Q000097:blood* / Q000150:complications*
chemical_list: D019798:Neopterin
keywords: Acute ischemic stroke; Chinese; Depression; Neopterin