[Effects of immunological and metabolic parameters on the patient's functional outcome in the acute period of ischemic stroke].

OBJECTIVE

To analyze the effect of metabolic disorders and immunological parameters on the functional outcome (FO) of acute ischemic stroke (IS) in patients with metabolic syndrome (MS).

MATERIAL AND

METHODS

298 patients in the acute period of IS were assessed. All patients were divided into two groups: Group 1 included 158 MS patients with a history of IS; Group 2 included 140 post-stroke patients without MS. The assessment included measurements of waist circumference, triglycerides (TG), low and high density lipoproteins (LDL/HDL), glucose, serum interleukins (IL-1b, IL-6, IL-16, IL-8), interferon gamma (IFN-g), tumor necrosis factor-alpha (TNF-α), macrophage migration inhibitory factor (MIF), monocyte chemotactic proteins (MCP-1/CCL2, MCP-3/CCL7), and macrophage inflammatory proteins (MIP-1a/CCL3, MIP-1d/CCL15). Patient disability rates measured by the modified Rankin Scale (mRS) at Day 21 from the IS onset were considered as FO parameters.

RESULTS

The FO evaluation revealed a significant (p<0.0001) prevalence of patients with an unfavorable/relatively unfavorable outcome (mRS ≥3) in Group 1. In the cohort of MS patients, multivariate mathematical analysis (correlation analysis and machine learning methods) showed the relationship of FO with the levels of LDL (r=0.520, p.d.=0.055), glucose (r=0.850, p.d.=0.089), the number of metabolic factors (r=0.880, p.d.=0.111), the concentrations of CCL3 (r=0.840, p.d.=0.354), CCL2 (r=0.520, p.d.=0.281), and MIF (r=0.830, p.d.=0.156).

CONCLUSION

A worse FO score was observed in patients with MS than in metabolically healthy patients, and this was associated with hypercholesterolemia, hyperglycemia, the number of metabolic factors, and the expression of CCL3, CCL2, and MIF.