Abstract
BackgroundFasting C-peptide (FCP) has been shown to play an important role in the pathophysiology of mood disorders including depression and schizophrenia, but it is unknown whether it also predicts post-stroke depression (PSD). This study examined the association between FCP and PSD at 6 months after acute ischemic-stroke onset among Chinese subjects.MethodsA total of 656 stroke patients were consecutively recruited from three hospitals of Wuhan city, Hubei province. Clinical and laboratory data were collected on admission. PSD status was evaluated by DSM-V criteria and 17-item Hamilton Rating Scale for Depression (HAMD-17) at 6 months after acute ischemic stroke. The χ2-test, Mann-Whitney U-test, and t-test were used to check for statistical significance. Multivariate logistic regression model was used to explore independent predictor of PSD.ResultsIn the univariate analysis, significant differences were found between the PSD and non-PSD groups in terms of FCP level (p = 0.009). After multivariate adjustments, FCP remained a significant independent predictor of PSD, with an adjusted odds ratio of 1.179 (95%CI: 1.040–1.337, p = 0.010).ConclusionsHigher FCP levels on admission were found to be associated with PSD at 6 months after acute ischemic-stroke onset. For stroke patients, doctors should pay attention to the baseline FCP for screening high-risk PSD in clinical practice.
Highlights
Fasting C-peptide (FCP) has been shown to play an important role in the pathophysiology of mood disorders including depression and schizophrenia, but it is unknown whether it predicts post-stroke depression (PSD)
Baseline characteristics In total, 656 patients with acute ischemic stroke were consecutively recruited in this study
The PSD and non-PSD groups did not differ in terms of age or Body mass index (BMI), but the PSD group had a higher proportion of female (p = 0.013), lower education level (p = 0.004), longer hospitalized time (p = 0.002), shorter sleep time (p = 0.002), higher National Institutes of Health Stroke Scale (NIHSS) score (p < 0.001), lower Barthel index (BI) score (p < 0.001), higher m Modified Rankin Scale (RS) score (p = 0.002), lower Conner-Davidson Resilience Scale (CD-RISC) score (p = 0.008) and higher neuroticism score (p = 0.027)
Summary
Fasting C-peptide (FCP) has been shown to play an important role in the pathophysiology of mood disorders including depression and schizophrenia, but it is unknown whether it predicts post-stroke depression (PSD). This study examined the association between FCP and PSD at 6 months after acute ischemic-stroke onset among Chinese subjects. Previous studies have demonstrated that PSD is associated with an increase in the serum levels of some inflammatory cytokines, such as interleukins IL-1β, IL-6, IL-18, intracellular adhesion molecule 1, tumor necrosis factorα(TNF-α) and c-reactive protein (CRP) [8,9,10]. Measuring C-peptide levels can better reflect the function of islet β cell synthesis and the secretion of endogenous insulin, which is widely used in clinical practice. Currently it is well established that this peptide has significant biological functions, which has both anti-inflammatory and pro-inflammatory effects in the body [20,21,22]
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