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Cortisol axis abnormalities early after stroke--relationships to cytokines and leptin
A Johansson1, B Ahrén, B Näsman
1Department of Medicine, Umeâ University Hospital, Umeâ, Sweden. Asa.Johansson@medicin.umu.se
Journal of Internal Medicine
|February 26, 2000
Summary
Early after stroke, proinflammatory cytokines like IL-6 influence neuroendocrine changes. These include altered cortisol and leptin levels and diurnal rhythms, impacting stroke recovery.
Area of Science:
- Neuroendocrinology
- Stroke Medicine
- Immunology
Background:
- Stroke triggers significant physiological responses, including inflammation and neuroendocrine alterations.
- Understanding these early post-stroke changes is crucial for predicting outcomes and developing interventions.
Purpose of the Study:
- To investigate the relationship between circulating proinflammatory cytokines, adrenocortical hormones, and leptin in the acute phase following stroke.
- To assess the impact of these factors on diurnal variations and cognitive/functional outcomes.
Main Methods:
- Blood samples were collected frequently during the first week post-stroke from patients and healthy volunteers.
- Measured biomarkers included interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), cortisol, dehydroepiandrosterone (DHEA), and leptin.
- Cognitive and functional assessments (MMSE, SSS, ADL) were performed at admission and day 7.
Main Results:
- Elevated IL-6 correlated with cortisol levels and stroke severity (paresis, MMSE scores).
- Patients with disturbed cortisol diurnal rhythms showed increased cortisol and leptin levels.
- Half of the patients exhibited abnormal diurnal leptin rhythms by week's end; TNF-alpha correlated with later leptin levels.
Conclusions:
- Neuroendocrine disturbances, including altered diurnal rhythms of cortisol and leptin, are prevalent early after stroke.
- Proinflammatory cytokines appear to play a key role in modulating these neuroendocrine changes post-stroke.