title: High serum pentosidine in branch atheromatous disease among small vessels occlusion.
abstract: BACKGROUND
  Cerebral branch atheromatous disease (BAD) are more likely to experience progressing stroke and neurological deterioration compared with lacunar infarction, although these small vessels occlusions are difficult to discriminate in acute phase of ischemic stroke. Advanced glycation end products including pentosidine have been implicated in atherosclerosis, and were associated with atheroma plaque progression. However, little is known about a relationship between serum pentosidine and small vessels occlusion.
  
  
  METHODS
  Serum pentosidine levels were measured in 56 patients (BAD: N.=21; lacunar: N.=35) with small vessels occlusion among consecutive 208 patients with acute ischemic stroke at initial hospitalization as well as other risk factors of stroke. Univariate and multivariate logistic regression analyses were performed to analyze relationship between risk factors including pentosidine and small vessels occlusion. Sensitivity and selectivity of pentosidine to discriminate BAD from lacunar were calculated.
  
  
  RESULTS
  Serum pentosidine was significantly higher in BAD group than lacunar group (0.081±0.081 µg/mL and 0.046±0.043 µg/mL, P<0.05). In the univariate logistic regression analyses, BAD was significantly related to high serum pentosidine (P=0.01), absence of dyslipidemia (P=0.04), and worse outcome measured by modified Rankin Scale (P=0.03). Multivariate logistic regression analysis showed that only high level of serum pentosidine was the independent risk factor for BAD (P=0.03). Sensitivity and specificity were 90% and 44%, respectively.
  
  
  CONCLUSIONS
  High level of serum pentosidine in acute phase of stroke was associated with BAD, which led to worse outcome among patients with small vessels occlusion.
authors.affiliation: Department of Cerebrovascular Surgery and Stroke Center, International Medical Center, Saitama Medical University, Saitama, Japan - schwein0920@me.com.|Department of Neurosurgery, Akiru Municipal Medical Center, Tokyo, Japan - schwein0920@me.com.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Ikeda
authors.affiliation: Department of Neurosurgery, Akiru Municipal Medical Center, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Maruyama
authors.affiliation: Department of Neurosurgery, Akiru Municipal Medical Center, Tokyo, Japan.|Department of Neurosurgery, Sasa General Hospital, Tokyo, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ito
authors.affiliation: Department of Neurosurgery, Sasa General Hospital, Tokyo, Japan.|Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Utagawa
authors.affiliation: Department of Neurosurgery, Akiru Municipal Medical Center, Tokyo, Japan.|Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shimada
authors.affiliation: Department of Neurosurgery, Akiru Municipal Medical Center, Tokyo, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shiokawa
authors.affiliation: Department of Cerebrovascular Surgery and Stroke Center, International Medical Center, Saitama Medical University, Saitama, Japan.|Department of Neurosurgery, Akiru Municipal Medical Center, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kurita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D018450:Disease Progression; D005260:Female; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000175:diagnosis / Q000473:pathology*; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D001120:Arginine; C062187:pentosidine; D008239:Lysine