Body mass index and leptin levels in serum and cerebrospinal fluid in relation to delayed cerebral ischemia and outcome after aneurysmal subarachnoid hemorrhage.
Body mass index
Delayed cerebral ischemia
Fat metabolism
Leptin
Subarachnoid hemorrhage
Journal
Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
02
02
2021
accepted:
07
04
2021
revised:
24
03
2021
pubmed:
19
4
2021
medline:
18
11
2021
entrez:
18
4
2021
Statut:
ppublish
Résumé
Aneurysmal subarachnoid hemorrhage (SAH) is associated with a high mortality rate and may leave surviving patients severely disabled. After the initial hemorrhage, clinical outcome is further compromised by the occurrence of delayed cerebral ischemia (DCI). Overweight and obesity have previously been associated with protective effects in the post-bleeding phase. The aim of this study was to assess the effects of a patient's body mass index (BMI) and leptin levels on the occurrence of DCI, DCI-related cerebral infarction, and clinical outcome. In total, 263 SAH patients were included of which leptin levels were assessed in 24 cases. BMI was recorded along disease severity documented by the Hunt and Hess and modified Fisher scales. The occurrence of clinical or functional DCI (neuromonitoring, CT Perfusion) was assessed. Long-term clinical outcome was documented after 12 months (extended Glasgow outcome scale). A total of 136 (51.7%) patients developed DCI of which 72 (27.4%) developed DCI-related cerebral infarctions. No association between BMI and DCI occurrence (P = .410) or better clinical outcome (P = .643) was identified. Early leptin concentration in serum (P = .258) and CSF (P = .159) showed no predictive value in identifying patients at risk of unfavorable outcomes. However, a significant increase of leptin levels in CSF occurred from 326.0 pg/ml IQR 171.9 prior to DCI development to 579.2 pg/ml IQR 211.9 during ongoing DCI (P = .049). In our data, no association between obesity and clinical outcome was detected. After DCI development, leptin levels in CSF increased either by an upsurge of active transport or disruption of the blood-CSF barrier. This trial has been registered at ClinicalTrials.gov (NCT02142166) as part of a larger-scale prospective data collection. BioSAB: https://clinicaltrials.gov/ct2/show/NCT02142166.
Identifiants
pubmed: 33866464
doi: 10.1007/s10143-021-01541-1
pii: 10.1007/s10143-021-01541-1
pmc: PMC8593057
doi:
Substances chimiques
Leptin
0
Banques de données
ClinicalTrials.gov
['NCT02142166']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3547-3556Subventions
Organisme : This work was supported by the START-Program of the Faculty of Medicine, RWTH Aachen, Germany
ID : grant number 691540
Informations de copyright
© 2021. The Author(s).
Références
J Leukoc Biol. 2000 Oct;68(4):437-46
pubmed: 11037963
Cerebrovasc Dis. 2011;32(2):170-6
pubmed: 21849776
Proc Natl Acad Sci U S A. 1996 Aug 6;93(16):8374-8
pubmed: 8710878
Cent Eur Neurosurg. 2010 Nov;71(4):163-6
pubmed: 20373277
World Neurosurg. 2017 Sep;105:732-736
pubmed: 28642182
J Neurosurg. 2019 Aug 23;:1-9
pubmed: 31443072
Neurosurgery. 2013 Aug;73(2):201-8
pubmed: 23632760
Neurosurgery. 2015 Feb;76(2):136-41
pubmed: 25549185
Neuroepidemiology. 2008;30(2):93-100
pubmed: 18309248
Neurosurg Rev. 2020 Dec;43(6):1555-1563
pubmed: 31664582
Stroke. 2010 Oct;41(10):2391-5
pubmed: 20798370
Stroke. 2015 Jul;46(7):1826-31
pubmed: 25977276
Clin Nutr. 2019 Feb;38(1):48-79
pubmed: 30348463
Eur Rev Med Pharmacol Sci. 2014;18(24):3954-8
pubmed: 25555890
Stroke. 2011 Apr;42(4):924-9
pubmed: 21311062
Rev Esp Cardiol (Engl Ed). 2015 Aug;68(8):672-9
pubmed: 25618563
Neurosurgery. 2018 Nov 1;83(5):E220
pubmed: 30203019
J Neurol Neurosurg Psychiatry. 2007 Dec;78(12):1365-72
pubmed: 17470467
Front Neurol. 2019 Feb 21;10:136
pubmed: 30858818
J Neurosurg. 2017 Jul;127(1):36-46
pubmed: 27419827
J Neurosurg. 2005 Jun;102(6):998-1003
pubmed: 16028757
Neurosurgery. 2019 May 1;84(5):1035-1042
pubmed: 29659999
World Neurosurg. 2015 Dec;84(6):1598-604
pubmed: 26187112
Science. 1995 Jul 28;269(5223):543-6
pubmed: 7624777
Nutr Neurosci. 2014 Sep;17(5):230-3
pubmed: 24075245
Stroke. 2019 Apr;50(4):837-844
pubmed: 30869562
Neurosurgery. 2017 Jun 1;80(6):942-949
pubmed: 28201539
Peptides. 2013 Oct;48:70-4
pubmed: 23954475
Springerplus. 2016 May 27;5(1):667
pubmed: 27350906
J Neurosurg. 2018 Nov 1;129(5):1125-1129
pubmed: 29219759
J Clin Endocrinol Metab. 1997 Sep;82(9):3084-6
pubmed: 9284748
Nature. 1998 Oct 22;395(6704):763-70
pubmed: 9796811
BMC Anesthesiol. 2017 Aug 31;17(1):118
pubmed: 28859605
J Neurol Neurosurg Psychiatry. 2001 Mar;70(3):340-3
pubmed: 11181855
J Cereb Blood Flow Metab. 2011 Jul;31(7):1545-53
pubmed: 21505477
Neurology. 2011 Feb 8;76(6):567-73
pubmed: 21228300
Curr Neurol Neurosci Rep. 2019 Aug 29;19(10):78
pubmed: 31468197
Int J Obes (Lond). 2010 May;34(5):791-9
pubmed: 20125098
Peptides. 2012 Jun;35(2):166-71
pubmed: 22764368
N Engl J Med. 1996 Feb 1;334(5):292-5
pubmed: 8532024
J Neurol Neurosurg Psychiatry. 2015 Jul;86(7):743-7
pubmed: 25209415
Thorax. 2011 Jan;66(1):66-73
pubmed: 20980246