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Updated: May 8, 2026
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An In Vivo Assessment of Blood-Brain Barrier Disruption in a Rat Model of Ischemic Stroke
Published on: March 11, 2018
Elevated bilirubin after acute ischemic stroke linked to the stroke severity
Yun Luo1, Jingwei Li, Junfeng Zhang
1Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China; School of Life Science, Nanjing University, Nanjing 210093, China.
Summary
Serum bilirubin levels increase after acute ischemic stroke (AIS) and correlate with stroke severity. This study investigated early bilirubin changes in AIS patients, finding a significant link between elevated direct bilirubin (Dbil) and total bilirubin (Tbil) and stroke severity.
Area of Science:
- Neurology
- Biochemistry
- Clinical Medicine
Background:
- Previous research indicated a correlation between serum bilirubin levels and stroke severity in acute ischemic stroke (AIS) patients.
- Hyperbilirubinemia is prevalent in AIS, suggesting a potential role for bilirubin in stroke pathophysiology.
Purpose of the Study:
- To determine the specific changes in bilirubin levels during the early phase of AIS.
- To investigate the association between these early bilirubin changes and stroke severity.
Main Methods:
- Serum bilirubin (direct bilirubin [Dbil] and total bilirubin [Tbil]) and other biochemical markers were measured in 608 AIS patients and 188 transient ischemic attack (TIA) patients.
- National Institutes of Health Stroke Scale (NIHSS) scores were assessed concurrently with blood collection.
- Statistical analyses, including multivariable logistic regression, were used to evaluate the correlation between bilirubin levels and stroke severity, considering Oxford Community Stroke Project (OCSP) subtypes.
Main Results:
- Serum Dbil and Tbil levels were significantly higher in the AIS group compared to the TIA group.
- Elevated bilirubin levels (Dbil ≥ 6.84 μmol/L, Tbil ≥ 22.2 μmol/L) were significantly associated with higher NIHSS scores and overall stroke severity.
- The highest bilirubin levels and highest rates of elevated bilirubin were observed in the TACI (Total Anterior Circulation Infarction) subtype.
Conclusions:
- Serum Dbil and Tbil levels are elevated in the early phase of AIS.
- Increased bilirubin levels in AIS are significantly linked to stroke severity and specific stroke subtypes.
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