Elevated circulating homocysteine and high-sensitivity C-reactive protein jointly predicts post-stroke depression among Chinese patients with acute ischemic stroke.

Abstract

BACKGROUND:

Homocysteine (HCY) and high sensitivity C reactive protein (hs-CRP) were suggested to be involved in post-stroke depression (PSD), which is a frequent mood disorder after stroke. However, the combined effect of HCY and hs-CRP on PSD remains unclear.

METHODS:

A total of 598 acute ischemic stroke patients from 7 of 26 centers participating in the China Antihypertensive Trial in Acute Ischemic Stroke with HCY or hs-CRP measurements were included in this analysis. PSD status was evaluated by 24-item Hamilton Depression Rating Scale at 3 months after stroke.

RESULTS:

Two hundred and forty-one (40.30%) participants were considered as PSD. HCY and hs-CRP levels were not significantly different between PSD and non-PSD patients. Interesting, in a maximally adjusted model, the odds ratio (95% confidence interval) of PSD was 1.90 (1.18-3.06) for coexistence of HCY ≥ 14.65 μmol/l and hs-CRP ≥ 1.90 mg/l compared with the other levels (HCY < 14.65 μmol/l and/or hs-CRP < 1.90 mg/l). Adding combination of HCY and hs-CRP to a model containing conventional risk factors could significantly improve risk reclassification for PSD.

CONCLUSIONS:

Coexistence of both higher HCY and higher hs-CRP in the acute phase of ischemic stroke were associated with subsequent PSD, independently of established conventional risk factors.

• Authors: Jieyun Yin, Chongke Zhong, Zhengbao Zhu, Xiaoqing Bu, Tan Xu, Libing Guo, Xuemei Wang, Jintao Zhang, Yong Cui, Dong Li, Jianhui Zhang, Zhong Ju, Chung-Shiuan Chen, Jing Chen, Yonghong Zhang, Jiang He
• Journal: Clinica chimica acta; international journal of clinical chemistry (Clin Chim Acta) Vol. 479 Pg. 132-137 (Apr 2018) ISSN: 1873-3492 [Electronic] Netherlands
• PMID: 29325799 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright © 2018 Elsevier B.V. All rights reserved.

Chemical References

• Homocysteine
• C-Reactive Protein

Topics

• Acute Disease
• Brain Ischemia (blood, complications)
• C-Reactive Protein (analysis)
• China
• Depression (blood, complications)
• Female
• Homocysteine (blood)
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Stroke (blood, complications)