High Serum Levels of Malondialdehyde and 8-OHdG are both Associated with Early Cognitive Impairment in Patients with Acute Ischaemic Stroke

Zhihua Liu,Jincai He,Huihua Qiu,Huiping Shen,Yuntao Liu,Huijun Chen,Xinjie Tu

doi:10.1038/s41598-017-09988-3

Zhihua Liu, Jincai He + Show 5 more

Open Access

https://doi.org/10.1038/s41598-017-09988-3

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Abstract

Post-stroke cognitive impairment (PSCI) is an increasingly prevalent sequel after stroke that may associate with poor functional outcome and increased risk of recurrent stroke. We aimed to explore the relationship between oxidative stress biomarkers and the presence of PSCI. 193 first-ever acute ischaemic stroke patients were consecutively enrolled in the current study. The oxidative stress biomarkers malondialdehyde (MDA) and 8-hydroxydeoxyquanosine (8-OHdG) were measured within 24 h after admission. Cognition function was evaluated by the Mini-Mental State Examination (MMSE) at 1 month after stroke. Serum levels of 8-OHdG and MDA were both significantly higher in the PSCI (p < 0.001) compared with the non-PSCI group. Both the serum levels of both 8-OHdG and MDA were negatively correlated with the MMSE score. Receiver operating characteristic curve analysis was used to evaluate 8-OHdG and MDA as markers of a high risk of PSCI and produced area under curve values of 0.700 and 0.793. Adjusted logistic regression showed that serum 8-OHdG and MDA levels remained as independent markers of PSCI. High serum levels of malondialdehyde and 8-OHdG are associated with the presence of PSCI at 1 month after stroke.

Highlights

The oxidative stress pathway can produce oxidative damage of lipids and nucleic acids. 8-hydroxydeoxyquanosine (8-OHdG) and malondialdehyde (MDA) are common end-products of deoxyribonucleic acid (DNA) oxidation and lipid peroxidation, respectively, and can be detected in body fluid or brain in humans[8]
The major findings of the present study were the following: (1) compared with the non-Post-stroke cognitive impairment (PSCI) group, markedly increased serum levels of 8-OHdG and MDA were observed in patients with PSCI; (2) both 8-OHdG and MDA were negatively correlated with Mini-Mental State Examination (MMSE) scores; (3) the levels of both 8-OHdG and MDA showed significant diagnostic accuracy in discriminating patients with PSCI from non-PSCI; and (4) elevated serum 8-OHdG and MDA were independently associated with PSCI at 1 month post-stroke
To the best of our knowledge, this is the first report of increased serum 8-OHdG and MDA levels in patients with PSCI

Summary

Introduction

The oxidative stress pathway can produce oxidative damage of lipids and nucleic acids. 8-hydroxydeoxyquanosine (8-OHdG) and malondialdehyde (MDA) are common end-products of deoxyribonucleic acid (DNA) oxidation and lipid peroxidation, respectively, and can be detected in body fluid or brain in humans[8]. 8-hydroxydeoxyquanosine (8-OHdG) and malondialdehyde (MDA) are common end-products of deoxyribonucleic acid (DNA) oxidation and lipid peroxidation, respectively, and can be detected in body fluid or brain in humans[8]. The systemic oxidative stress response to acute ischaemic stroke involves increases in 8-OHdG and MDA, which have been associated with poor functional recovery[9] and mortality[10]. While higher peripheral blood levels of 8-OHdG11 and MDA12 have been associated with dementia, and some researchers have found that oxidative stress is related to cognition, without dementia or stroke[13], the association between 8-OHdG or MDA and PSCI has not been investigated. We measured serum levels of 8-OHdG and MDA within 24 h after admission in patients with acute ischaemic stroke, to determine whether oxidation products are associated with the presence of PSCI, and if so, at what concentrations

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