Emerging role of serum dickkopf-1 in prognosis of aneurysmal subarachnoid hemorrhage

Abstract

BackgroundWnt signaling pathway is involved in early brain injury after aneurysmal subarachnoid hemorrhage (aSAH). Dickkopf-1 acts as a secreted Wnt antagonist. We analyzed the relationship between dickkopf-1 concentrations and clinical outcomes of aSAH. MethodsSerum dickkopf-1 concentrations were determined in 132 aSAH patients and 100 control individuals using the enzyme-linked immunosorbent assay. patients' characteristics, the World Federation of Neurological Surgeons (WFNS) Scale and modified Fisher grade were assessed. At 3-month follow-up, functional outcome (Glasgow Outcome Scale score; dichotomized as poor [score 1–3] or good [score 4–5]) was recorded. The multivariate logistic regression model was constructed to discern the association of serum dickkopf-1 concentrations with outcome. ResultsCompared with controls, serum dickkopf-1 concentrations were substantially raised after aSAH. Dickkopf-1 concentrations were highly related to WFNS score and modified Fisher score. Patients with a poor outcome had significantly increased dickkopf-1 concentrations. In multivariate logistic regression analysis, serum dickkopf-1 appeared as an independent predictor of poor outcome. Receiver operating characteristic curve analysis showed that serum dickkopf-1 concentrations predicted poor outcome efficiently. ConclusionsSerum dickkopf-1 concentrations were strongly associated with the severity and poor outcome of aSAH, suggesting that serum dickkopf-1 may be a novel biomarker for predicting poor outcome in aSAH.