Worse Neurological State During Acute Ischemic Stroke is Associated with a Decrease in Serum Albumin Levels.

Joanna Bielewicz,Piotr Kamieniak,Jacek Kurzepa,Elżbieta Czekajska-Chehab,Konrad Rejdak,Halina Bartosik-Psujek,Beata Daniluk

doi:10.1007/s12031-015-0705-4

Abstract

High serum albumin levels during ischemic stroke (IS) decrease the risk of a poor outcome. This study aimed to determine whether serum albumin levels within the first days after IS correlate with radiological and biochemical markers of brain tissue damage. Fifty-six IS patients were enrolled into the study. Neurological examinations were based on the National Institute of Health Stroke Scale. Serum albumin levels and S100BB were evaluated using commercially available ELISA kits. The albumin decrease index (ADI) was calculated as the difference between serum albumin levels measured on days 1 and 10 of IS. All parameters were estimated on the 1st, 3rd, 5th, and 10th days of IS, and the volume of ischemic focus was measured on the 10th day. Mean serum albumin levels were decreased during acute IS. There were correlations between the ADI and mean S100BB serum levels (r = 0.36, p < 0.05), the volume of ischemic focus (r = 0.39, p < 0.05), and the patients’ neurological state when measured on day 10 of IS (r = 0.59, p < 0.001). A decrease in serum albumin levels during the acute phase of IS corresponds to a worse neurological state as a result of a large ischemic focus with intense catabolic processes.

Highlights

Previous studies have highlighted the favorable relationship of serum albumin levels on the outcome of patients experiencing ischemic stroke (IS) (Babu et al 2013; Baltanas et al 2009; Belayev et al 2002)
Baseline serum albumin levels were not correlated with mean S100BB serum levels (r = 0.16, p > 0.05) or the patients’ neurological state
albumin decrease index (ADI) was significantly correlated with mean S100BB serum levels (r = 0.36, p < 0.05), ischemic focus volume (IF) (r = 0.39, p < 0.05), and the patients’ neurological state (NIHSS score) on day 10 of stroke (r = 0.59, p < 0.001)

Summary

Introduction

Previous studies have highlighted the favorable relationship of serum albumin levels on the outcome of patients experiencing ischemic stroke (IS) (Babu et al 2013; Baltanas et al 2009; Belayev et al 2002). Small ischemic lesions are independently correlated with high serum albumin levels (Boselli et al 2012). A low serum albumin level is one of the predictive factors for a first-ever non-embolic stroke in older individuals (Buttner et al 1997). Some experimental studies have suggested a neuroprotective effect of albumin either by reducing brain edema (Chen et al 2013) or by its antioxidative or antiapoptotic properties (Ciuffetti et al 1988). Adequate levels of serum albumin lead to an improvement in microcirculatory flow, viscosity of plasma, and oxygen transport capacity (Defazio et al 2012).

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