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High serum levels of malondialdehyde and antioxidant enzymes are associated with post-stroke anxiety

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Abstract

Post-stroke anxiety (PSA) is a common neuropsychiatric affective disorder occurring after stroke. The purpose of this study was to investigate the association between anxiety and the serum levels of oxidative stress markers at admission. First-ever or recurrent ischemic stroke patients were consecutively recruited into the study and followed up 1 month. Patients were divided into PSA and non-PSA group according DSM-IV criteria for anxiety due to stroke. Overall, 49 patients (24.1%) were diagnosed anxiety. Serum GPX (glutathione peroxidase), CAT (catalase), SOD (superoxide dismutase), and MDA (malondialdehyde) were significantly higher in patients with anxiety than patients without anxiety. The HAM-A scores had a significant positive association with MDA levels. In multivariate logistic regression analysis, serum antioxidant enzymes and MDA were independent predictors of PSA. An increased risk of PSA was associated with serum MDA levels ≥ 3.0 nmol/ml (adjusted OR 8.68, 95% CI 3.02–24.95; P < 0.001) after adjusting for relevant confounders such as social support and treatments at admission. Elevated serum levels of lipid oxidation products and antioxidant enzymes at admission were associated with anxiety 1 month after stroke, suggesting that these alterations might participate in the pathophysiology of anxiety symptoms in stroke patients.

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Abbreviations

BMI:

Body mass index

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

NIHSS:

National Institutes of Health Stroke Scale

MMSE:

Mini-mental state examination

PSQI:

Pittsburgh Sleep Quality Index

SSRS:

Social Support Rating Scale

BI:

Modified Barthel Index

PSA:

Post-stroke anxiety

FBG:

Fasting blood glucose

TG:

Total cholesterol

Hs-CRP:

High-sensitivity C-reactive protein

GPX:

Glutathione peroxidase

CAT:

Catalase

SOD:

Superoxide dismutase

MDA:

Malondialdehyde

95% CI:

95% Confidence interval

OR:

Odds ratio

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Funding

This work was supported by the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (grant number: 2015BAI13B01) and Wenzhou Municipal Sci-Tech Bureau Program (grant number:Y20160002).

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Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325000, China

    Zhihua Liu, Yan Cai, Xingru Zhang, Zhuoying Zhu & Jincai He

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  1. Zhihua Liu
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  2. Yan Cai
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Correspondence to Jincai He.

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Liu, Z., Cai, Y., Zhang, X. et al. High serum levels of malondialdehyde and antioxidant enzymes are associated with post-stroke anxiety. Neurol Sci 39, 999–1007 (2018). https://doi.org/10.1007/s10072-018-3287-4

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  • DOI: https://doi.org/10.1007/s10072-018-3287-4

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