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Elevated circulating homocysteine and high-sensitivity C-reactive protein jointly predicts post-stroke depression

Jieyun Yin1, Chongke Zhong2, Zhengbao Zhu1

  • 1Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|January 13, 2018
PubMed

Insights

Elevated homocysteine (HCY) and high-sensitivity C-reactive protein (hs-CRP) levels in acute ischemic stroke patients are linked to a higher risk of developing post-stroke depression (PSD). This combined effect independently predicts PSD development.

Area of Science:

  • Neurology
  • Psychiatry
  • Biomarkers

Background:

  • Post-stroke depression (PSD) is a common complication following stroke.
  • Homocysteine (HCY) and high-sensitivity C-reactive protein (hs-CRP) are potential contributing factors to PSD.
  • The combined impact of HCY and hs-CRP on PSD risk remains under investigation.

Purpose of the Study:

  • To investigate the association between combined elevated levels of homocysteine (HCY) and high-sensitivity C-reactive protein (hs-CRP) and the incidence of post-stroke depression (PSD).

Main Methods:

  • A cohort of 598 acute ischemic stroke patients were analyzed.
  • PSD was assessed using the 24-item Hamilton Depression Rating Scale at 3 months post-stroke.
  • Statistical models were used to evaluate the combined effect of HCY and hs-CRP on PSD risk.

Main Results:

  • 40.30% of patients developed PSD.
  • Elevated HCY (≥14.65 μmol/l) and hs-CRP (≥1.90 mg/l) coexistence was associated with a 1.90-fold increased odds of PSD.
  • The combination of HCY and hs-CRP improved risk reclassification for PSD when added to conventional risk factors.

Conclusions:

  • The coexistence of high HCY and high hs-CRP levels during the acute phase of ischemic stroke is associated with an increased risk of subsequent PSD.
  • This association is independent of established conventional risk factors.
  • Combined HCY and hs-CRP levels may serve as valuable biomarkers for predicting PSD risk.
Abstract

Keywords:
Acute ischemic strokeHigh sensitivity C reactive proteinHomocysteinePost-stroke depression

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