Journal Article

Combination of High-Sensitivity C-Reactive Protein and Homocysteine Predicts the Post-Stroke Depression in Patients with Ischemic Stroke

Zhang, Li-Jun, Shen, Yuan, Ji, Kangxiang, Cheng, Li-Shan, Tu, Wen-Jun

2018

Overview

In this study, we examined the changes in high-sensitivity C-reactive protein (Hs-CRP) and homocysteine (HCY) levels, two of the risk factors, during the acute period of ischemic stroke (IS) and evaluated the relationship between these two factors and long-term post-stroke depression (PSD). In this study, 259 patients with IS had finished the follow-up and were included. Based on the symptoms, diagnoses of depression were made in accordance with DSM-IV criteria for depression at 1 year after stroke. The influence of Hs-CRP/CHY levels on PSD was performed by binary logistic regression analysis and receiver operating characteristic curves (ROC). Totally, 94 out of the 259 patients were diagnosed as PSD (36.3%; 95% CI 30.4–42.1%). In multivariate logistic regression analysis, the third and fourth quartiles of Hs-CRP or HCY were significantly associated with PSD during the observation period compared to the first quartile group ( P  < 0.05). In addition, patients with depression were older and more frequently were female, living with offspring, widowhood, higher initial stroke severity, and BMI. HCY improved the ability of Hs-CRP [0.72 (95% CI 0.66–0.79)] to diagnose PSD (AUC of the combined model 0.76; 95% CI 0.69–0.82; P  = 0.021). The patient group with higher levels of both Hs-CRP and HCY (> median) had an OR of 6.05 (95 % CI 3.13–10.15; P  < 0.001) for PSD compared with patients with lower levels of both factors (< median). The data suggests that elevated serum levels of Hs-CRP and HCY were associated with the risk of developing PSD 1 year after the stroke onset, and those two factors combined to add prognostic information in the early evaluation of PSD.

• Publisher: Springer US,Springer Nature B.V
• Subject: Adult / Aged / Biomedical and Life Sciences / Biomedicine / Brain Ischemia - blood / Brain Ischemia - complications / C-reactive protein / C-Reactive Protein - metabolism / Cell Biology / Depression - blood / Depression - epidemiology / Depression - etiology / Female / Follow-Up Studies / Health risk assessment / Homocysteine / Homocysteine - blood / Humans / Incidence / Ischemia / Logistic Models / Male / Mental depression / Middle Aged / Multivariate Analysis / Neurobiology / Neurology / Neurosciences / Regression analysis / Risk factors / ROC Curve / Serum levels / Stroke / Stroke - blood / Stroke - complications