Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：Stroke Vasc Neurol

Publication type: Article

IF(IF): 4.9

PMID: 41057170 Link To Pubmed Full text Download

In China, stroke is one of the main causes of death and long-term disability. Novel and useful biomarkers that can predict stroke poor outcome early are of great signifcance for improving patient prognosis and alleviating medical burden. Adiponectin, first identifed in 1995, is a 244–amino acid collagen-like protein. It is secreted by adipocytes and plays role in anti-infammatory and insulin-sensitizing properties. The dysregulation of adiponectin has been implicated in obesity, metabolic syndrome, type 2 diabetes, hypertension, and cardiovascular disease. Basic science studies have shown beneficial effects of adiponectin on glucose homeostasis, chronic low-grade inflammation, apoptosis, oxidative stress, and atherosclerotic processes, so this molecule usually has been considered a salutary adipokine. It was quite unexpected that large prospective human studies suggested that adiponectin is simply a marker of glucose homeostasis, with no direct favorable effect on the risk of type 2 diabetes and cardiovascular disease. But even more unforeseen were data addressing the role of adiponectin on the risk of death. In fact, a positive, rather than the expected negative, relationship was reported between adiponectin and mortality rate across many clinical conditions, comprising stroke. The biology underlying this paradox is unknown. The objective of this study was to investigate the association of adiponectin with poor outcomes in new acute ischemic stroke (AIS) patients in China.

Patients were divided into four groups according to the quartiles of adiponectin. Continuous variables were presented as medians and interquartile ranges (IQR) due to showed distribution and were compared by nonparametric Wilcoxon or Kruskal–Wallis test. Categorical variables were presented as frequencies with percentages and were compared by the chi-square test or Fisher’s exact test. Hazard ratio (HR) and 95% confidence interval (CI) were calculated for stroke recurrence and death using Cox proportional hazards model. For poor functional outcome, logistic regression model was used to calculate odds ratio (OR) and 95% CI. We fitted an unadjusted model and two adjusted models for each outcome. Model 1 is adjusted by age, and sex; Model 2 is model 1 plus educational level, family income,BMI, cardiovascular risk factors (smoking, drinking, lipid metabolism disorders, diabetes, heart disease, CHD, AF, HF), in-hospital treatment (antiplatelet, anticoagulation, and hypoglycemictherapy), laboratory information (Cr, T-CHOL, LDL-C, HDL-C, TG, and blood glucose) and TOAST classification; P-trend for linearity of hazard ratio of proportional hazard regression model. A two-sided P values ＜0.05 was considered to indicate statistical significance. All statistical analyses were performed with SAS and R software.