title: Prediction of Outcome in Diabetic Acute Ischemic Stroke Patients: A Hospital-Based Pilot Study Report.
abstract: BACKGROUND
  Demographic and clinical characteristics are known to influence the outcome in acute ischemic stroke (AIS) patients.
  
  
  OBJECTIVE
  This study is aimed at evaluating short- and long-term outcomes in diabetic AIS patients. In addition, the study also evaluates the impact of diabetes on the performance of indigenously reported biomarker, inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4) and known biomarkers, neuron-specific enolase (NSE) and glial-derived S-100 beta beta protein (S-100ββ).
  
  
  METHODS
  This study was performed on 29 diabetes and 75 non-diabetes AIS patients. Outcome of AIS patients was analyzed by using modified Rankin scale at discharge, then at 12 and 18 months after discharge. Based on the obtained scores, patients were classified as improved group (scales 1-3) and dependent/expired group (scales 3-6). Blood samples were collected during admission and at discharge/expired time. Levels of NSE, S100ββ, and ITIH4 were analyzed in all samples.
  
  
  RESULTS
  On discharge, frequencies of dependent/expired outcome were 4/29 (14%) and 19/75 (17%) in diabetic and non-diabetic AIS patients. However, follow-up outcome at 12 and 18 months showed higher dependent/expired cases of 43 and 41% among diabetic AIS patients compared to 27 and 21% in non-diabetic patients. Multivariate analysis revealed that diabetes is an independent risk factor for dependent/expired outcome in AIS patients (OR 0.484 (at discharge); 1.307 (at 12 months) and 1.675 (at 18 months)). NSE, S100ββ, and ITIH4 showed a differential expression in both the outcome groups of AIS patients, irrespective of diabetes.
  
  
  CONCLUSIONS
  Diabetes increases the risk of dependent/expired outcome in AIS patients. Also, serum NSE, S100ββ, and ITIH4 are independent biomarkers for prognosis of outcome in AIS patients, irrespective of diabetes.
authors: Biochemistry Research Centre, Central India Institute of Medical Sciences, Bajaj Nagar, Nagpur, India.
authors: Amit R
authors: AR
authors: Nayak
authors: MDS Bioanalytics Pvt. Ltd., Sakar Enclave, Nagpur, India.
authors: Shweta R
authors: SR
authors: Badar
authors: Biochemistry Research Centre, Central India Institute of Medical Sciences, Bajaj Nagar, Nagpur, India.
authors: Neha
authors: N
authors: Lande
authors: Biochemistry Research Centre, Central India Institute of Medical Sciences, Bajaj Nagar, Nagpur, India.
authors: Anuja P
authors: AP
authors: Kawle
authors: Biochemistry Research Centre, Central India Institute of Medical Sciences, Bajaj Nagar, Nagpur, India.
authors: Dinesh P
authors: DP
authors: Kabra
authors: Biochemistry Research Centre, Central India Institute of Medical Sciences, Bajaj Nagar, Nagpur, India.
authors: Nitin H
authors: NH
authors: Chandak
authors: MDS Bioanalytics Pvt. Ltd., Sakar Enclave, Nagpur, India.
authors: Dhananjay V
authors: DV
authors: Raje
authors: Biochemistry Research Centre, Central India Institute of Medical Sciences, Bajaj Nagar, Nagpur, India.
authors: Lokendra R
authors: LR
authors: Singh
authors: Biochemistry Research Centre, Central India Institute of Medical Sciences, Bajaj Nagar, Nagpur, India.
authors: Hatim F
authors: HF
authors: Daginawala
authors: Biochemistry Research Centre, Central India Institute of Medical Sciences, Bajaj Nagar, Nagpur, India.
authors: Rajpal S
authors: RS
authors: Kashyap
keywords: Acute ischemic stroke; Biomarkers; Diabetes mellitus; Inter-alpha-trypsin inhibitor heavy chain 4 protein; Neuron-specific enolase