Abstract
Inflammatory processes have fundamental roles in depression. The primary purpose of this study was to assess the serum levels of high-sensitivity C-reactive protein (Hs-CRP) and homocysteine (HCY) at admission to the presence of poststroke depression (PSD). From December 2012 to December 2013, first-ever acute ischemic stroke patients who were admitted to the hospital within the first 24 h after stroke onset were consecutively recruited and followed up for 6 months. Serum levels of Hs-CRP and HCY were tested at admission. Based on the symptoms, diagnoses of depression were made in accordance with DSM-IV criteria for depression at 6 months after stroke. Ninety-five patients (42.0 %) showed depression (major + minor) at 6 months after admission, and in 69 patients (30.5 %), this depression was classified as major. In the 69 patients with major depression, our results showed significantly higher Hs-CRP and HCY levels at admission than patients without major depression. After adjusting all other possible covariates, Hs-CRP and HCY still were independent predicators of PSD with adjusted OR of 1.332 (95 % CI, 1.230–1.452; P < 0.001) and 1.138 (95 % CI, 1.072–1.274; P < 0.001), respectively. The area under the receiver operating characteristic curve values of Hs-CRP and HCY were 0.765 (95 % CI, 0.701–0.9825) and 0.684 (95 % CI, 0.610–0.757) for PSD, respectively. The prognostic accuracy of combined model (HCY and Hs-CRP) was higher compared to those biomarkers alone and other markers. Elevated serum levels of Hs-CRP and HCY at admission were found to be associated with depression 6 months after stroke, suggesting that these alterations might participate in the pathophysiology of depression symptoms in stroke patients.
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Acknowledgments
This work was supported by the National Natural Science Foundation of China (No: 31170733) and the Doctoral Scientific Research Start-up Foundation of Henan Normal University. We also express our gratitude to all the patients, the nurses, and physicians who participated in this study and thereby made this work possible.
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Chao-Zhi Tang and Yu-Ling Zhang contributed equally to this work.
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Tang, CZ., Zhang, YL., Wang, WS. et al. Serum Levels of High-sensitivity C-Reactive Protein at Admission Are More Strongly Associated with Poststroke Depression in Acute Ischemic Stroke than Homocysteine Levels. Mol Neurobiol 53, 2152–2160 (2016). https://doi.org/10.1007/s12035-015-9186-2
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DOI: https://doi.org/10.1007/s12035-015-9186-2