Abstract
Previous studies indicated that both inflammatory responses and hyperglycemia are involved in the similar pathophysiological mechanisms after onset of intracerebral hemorrhage (ICH). However the relationship between hyperglycemia and inflammation remains unknown. We aim to evaluate the associations of hyperglycemia with inflammation and neutrophil to lymphocyte ratio (NLR) in patients with ICH. Patients with acute ICH were retrospectively enrolled. Clinical characteristics and imaging features were obtained. The associations between outcome and laboratory biomarkers were assessed by multivariable logistic regression analysis. Spearman analysis and multiple linear regression analysis were performed to estimate the association of NLR and serum glucose. 175 patients were enrolled. Poor outcome occurred in 86 patients at 30 days. Elevated blood glucose level (BGL) and NLR were strongly associated with outcome in patients with ICH. Moreover, combined NLR-BGL exhibited a better predictive accuracy compared with the peripheral leukocyte counts. Furthermore, there was a robust association between BGL and NLR. We first demonstrated both of NLR and BGL were independently associated with each other. Our results indicate that inflammatory responses and the pathological process of hyperglycemia may influence each other by several complex pathological mechanisms and have a mutual promoting effect to secondary brain injury.
Highlights
Previous studies indicated that both inflammatory responses and hyperglycemia are involved in the similar pathophysiological mechanisms after onset of intracerebral hemorrhage (ICH)
The aim of this report is to estimate the association between hyperglycemia and inflammation in the ICH cohort, as well as a novel inflammatory marker known as neutrophil to lymphocyte ratio (NLR), which was recently reported to be identified as an ideal inflammatory predictor for functional outcome in ICH patients[9]
We excluded patients due to: (1) that ICH was attributable to trauma, brain neoplasm, aneurysm or arteriovenous malformation; (2) that a history of infection or obvious sign of acute/chronic infection was observed within 2 weeks; (3) unavailable computed tomography (CT) scans or follow-up data; (2) systemic diseases including lung cancer, chronic obstructive pulmonary disease, tuberculosis, autoimmune disease, severe renal dysfunction and so on; (4) consumption of immunosuppressant drug or anticoagulants; (5) a stroke history within 6 months displayed in the electric medical record
Summary
Previous studies indicated that both inflammatory responses and hyperglycemia are involved in the similar pathophysiological mechanisms after onset of intracerebral hemorrhage (ICH). We aim to evaluate the associations of hyperglycemia with inflammation and neutrophil to lymphocyte ratio (NLR) in patients with ICH. Elevated blood glucose level (BGL) and NLR were strongly associated with outcome in patients with ICH. Hyperglycemia and inflammatory responses were widely recognized to play a crucial role in the pathophysiological mechanism of ICH and lead to secondary brain injury[4,5,6,7]. The aim of this report is to estimate the association between hyperglycemia and inflammation in the ICH cohort, as well as a novel inflammatory marker known as neutrophil to lymphocyte ratio (NLR), which was recently reported to be identified as an ideal inflammatory predictor for functional outcome in ICH patients[9]
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